Woodburn Baptist Church

Church Planters Application

  1. Personal information:

Name______

Address______

City______State______Zip______

Phone______E-mail______

Date of birth______Place of birth______

Marital status: ___Single ___Married ___Re-married

Spouse name______Spouse date of birth______

Spouse place of birth______

Have you or your spouse ever been divorced? ___Yes ___No

If yes, please explain the circumstances below.

______

______

______

______

______

How many Children do you have? ______Ages: ______

Is this the first time you have applied to be a church planting partner? ___Yes ___No

Are you ordained? ____Yes ___No If so, date: ______

Would you please supply your SS number for the purpose of running a credit report and background check?

SS # ______

  1. Education:

Name of institution Major Years attended Degree

______

______

______

______

  1. Health: Do you or your family have any health issues that would prevent you from fulfilling this partnership? ___No ___Yes If yes, please explain: ______

______

  1. If selected as a church planter sent by WBC, will you agree to abide by the accountability outline as described in the attached document, Partnering with New Churches, “Procedure” paragraph #4 items a -g? ___Yes ___No
  1. Evangelism/Discipleship:
  2. Are you active in personal witness? ___Yes ___No
  3. Approximately how many people have you witnessed to one on one in the last year? __
  4. How many people are you currently discipling? ___
  5. Please list the name and contact information of one of the disciples referenced in item “c” above.
  6. How many people do you estimate you have discipled? ____
  7. Please list the name and contact information of one of the disciples referenced in item “e” above.
  8. State your definition of “discipleship” ______

______

______

  1. Please describethe following:
  2. Your conversion experience.
  3. The current condition of your relationship with the Lord.
  4. The calling you feel to plant a church.
  5. List any previous church planting experience.
  6. List the names and contact information of those who will vouch for you and confirm the information above.

Note: Attach as many additional sheets as you wish.

  1. Partnership level requested:
  2. Select from the attached document, Partnering with New Churches, under the sub-heading “Levels”, items 1-3, which level of support you are requesting:
  3. Level 1: Relationship
  4. Level 2: Leadership
  5. Level 3: Sponsorship
  6. Other (please explain)
  7. If requesting level 3 support, please attach a full financial statement and planned time line for church plant.
  1. Please supply the names, addresses and phone numbers of your launch team/core group.
  1. Please review and confirm your agreement with Woodburn Baptist Churches statement of believe found on our website at

Signed: ______Date ______

Note: Information contained in this application will be confidentially reviewed by selected WBC groups.

When completed, mail to:

Woodburn Baptist Church,

Attn. Deacon Chairman

P.O. Box 38

Woodburn, KY 42170

Document Date: 15-May-16 c:\users\treasurer\desktop\dropbox\awwwjw\wbc_partnering_with_new_churches_application.docx1 of 3