North American Missions Status PERSONAL INFORMATION Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Birthdate * MM DD YYYY Marital Status * Married Divorced Separated Widowed Single Other MINISTERIAL STATUS What District is your license presently with? * Name of Your District Superintendent * Name of your Presbyter * Name of your NAM Director * Current Ministerial Credentials * Local General Ordained Name(s) of current pastor. * Name(s) of former pastor(s) from last 10 years. * Please give a brief description of your church history and ministerial involvement from the last decade. * Do you currently pastor a church? * Yes No TARGET CITY INFORMATION What is your target city? * Population of target city * Please take a moment to express your burden for this city * What is the average income level in the city? * Low Medium High What level is the cost of living in this city? * Low Medium High What level is the cost of rent in this city? * Low Medium High What is the main industry of the city? * Please explain whether you think this is a growing area or not * If approved, when would you be able to move on location? * NAMES OF 3 CLOSEST UPC CHURCHES Pastor's name of Church One * First Name Last Name Church One name * Distance of Church One from your target location * Pastor's name of Church Two * First Name Last Name Church Two name * Distance of Church Two from your target location * Pastor's name of Church Three * First Name Last Name Church Three name * Distance of Church Three from your target location * Do you already know any Pentecostals in this city? * Yes No Have you made contact with people from the city? * Yes No When do you plan to begin conducting services? * In what language(s) do you plan to conduct services? * What facilities do you plan to use? * EDUCATIONAL BACKGROUND Where did you attend high school? (Name, City, State) * Did you graduate? * Yes No Did you attend college/university? * Yes No Did you attend any other institution of learning? * Yes No FAMILY INVOLVEMENT How many children do you have under the age of 18? * 1 2 3 4 5 6+ Please list the names and birthdates of each of your children * Please explain the current state of your health * Do you have any other dependents? * Yes No Please list all of the general musical talents that you or your family possess * If you are relocating, what are your plans for housing, employment, etc.? * DOCTRINE NORTH AMERICAN MISSIONS STATUS PERSONAL INFORMATION NAME First Name Last Name ADDRESS Address Line 1 Address Line 2 City State SELECT... Country UNITED STATES Zip Code Phone Number (201) 555-0123 Email Your Birthdate mm/dd/yyyy Marital Status SELECT... MINISTERIAL STATUS What District is your license presently with? Name of Your District Superintendent Name of your Presbyter Name of your NAM Director Current Ministerial Credentials Local General Ordained Name(s) of current pastor. Name(s) of former pastor(s) from last 10 years. Please give a brief description of your church history and ministerial involvement from the last decade. Do you currently pastor a church? Yes No TARGET CITY INFORMATION What is your target city? Population of target city Please take a moment to express your burden for this city WHAT IS THE ECONOMIC CONDITION OF THIS CITY? Income SELECT... Cost of Living SELECT... Rent SELECT... What is the main industry of the area? Please explain whether you think this is a growing area or not If approved, when would you be able to move on location? NAMES OF THE THREE CLOSEST UPC CHURCHES PASTOR'S NAME OF CHURCH ONE First Name Last Name Church One Name Distance of Church One from your target location PASTOR'S NAME OF CHURCH TWO First Name Last Name Church Two Name Distance of church two from your target location PASTOR'S NAME OF CHURCH THREE First Name Last Name Church three name Distance of church three from your target location Do you already know any Pentecostals in this city? SELECT... Have you made contact with people from the city? SELECT... When do you plan to begin conducting services? In what language(s) do you plan to conduct services? What facilities do you plan to use? EDUCATIONAL BACKGROUND Where did you attend high school? (Name, City, State) Did you graduate? SELECT... Did you attend a university? Yes No Did you attend any other institution of learning? Yes No FAMILY INVOLVEMENT How many children do you have under the age of 18? SELECT... Please list the names and birthdates of each of your children Please explain the current state of your health Do you have any other dependents? SELECT... Please list all of the general musical talents that you or your family possess If you are relocating, what are your plans for housing, employment, etc.? DOCTRINE What do you preach to be essentials as biblical requirements for salvation? * What is your approach to presenting the message of salvation? * How do you interpret the biblical requirement of holiness? * What is your approach to teaching holiness to new converts? * What types of convictions do you have concerning technology and media? * GENERAL Will you cooperate with all Illinois District programs? * Yes No Will you cooperate with the Illinois District NAM Department and the vision of our Director? * Yes No Do you agree to all NAM Policy, including submitting monthly reports while on status? * Yes No Will you affiliate your assembly with the United Pentecostal Church International? * Yes No What is the minimum length (in years) that you feel a pastor should stay at a new work before moving on to another work? * 1 2 3 4 5 6+ Have you been a regular supporter of District programs? * Yes No On average, how much would you say that you give to "Christmas for Christ" each year? * In what specific ways to you practice personal evangelism and discipleship? * If approved, what ideas will implement to evangelize and make disciples in your city? * SECULAR EMPLOYMENT Will you be requesting any type of financial support? * Yes No Undecided Please briefly explain your experience in secular work * Do you have any church construction experience? * Yes No MINISTERS ON-SITE IMPORTANT: Are you already ministering on-site where the church is gathering regularly? * Yes No PERSONAL FINANCES What is your annual household income? * $20,000-$30,000 $30,000-$40,000 $40,000-$50,000 $50,000-$60,000 $60,000-$70,000 $70,000-$80,000 $80,000-$90,000 $90,000-$100,000 $100,000+ Do you anticipate that staying the same once you launch the church? * Yes No What are your total personal monthly expenses? * Have you declared bankruptcy in the last 7 years? * Yes No Are you current on all of your debts (including mortgage, loans, utilities, etc.)? * Yes No Do you tithe to your District? * Yes No Do you authorize the Illinois District to run credit and/or background checks in your name as we deem necessary? * Option 1 Option 2 Please digitally sign your name here: * Thank you!
