Mount Olive Missionary Baptist Church
Post Office Box 214 s Lewiston, North Carolina 27849 s (252) 348-2644
PASTORAL APPLICATION
(Please send a recent photo and an audiotape. Information is to be typewritten.)
SECTION I - PERSONAL INFORMATION
Name:
First Middle Last (include maiden name, if applicable)
Mailing Address______
Residency: ______
Length of time at current address______
Telephone: (Home) (Work) ______
Email Address______Personal website Address______
Preferred Contact Address:
Preferred Telephone Contact: r Home r Work r Mobile
SSN: (last 4 digits) Date of Birth ______Age: ______
If hired, can you present proof of your legal right to live and work in this country? Yes No N/A
Citizenship______Birthplace: ______
Date and Place Licensed: By what Denomination:
(Submit copy of License Certificate)
Are you ordained? Yes No
Date and Place Ordained: By what Denomination:
(Submit a copy of Ordination Certificate)
Are you a certified /licensed counselor? Yes No
Organizational memberships and affiliations:
Mount Olive Missionary Baptist Church Application Form
Have you ever filed for bankruptcy? Yes No
If yes, please state the nature and circumstances of the bankruptcy.
______
______
§ Background Information
Please answer the following questions. (Use an additional sheet to include a statement explaining the circumstances to any affirmative answers.)
(1) During your term as pastor of any church, have you ever been dismissed from a pastorate or ministerial position or been the subject of any dismissal proceeding in the ministry? r Yes r No
(2) Have you ever suffered from alcohol, drug, and/or sexual addiction? r Yes r No
(3) Have you ever been charged with a felony or misdemeanor? r Yes r No
(4) Have you ever been convicted of a felony or misdemeanor? r Yes r No
(5) Have you ever been incapacitated by an illness during the last 5 years? r Yes r No
(6) Are you currently under a doctor’s care for any physical or mental disability? r Yes r No
If you answered yes to either of the previous questions, please state the nature of the crime(s) when you were convicted and the disposition of the case on the attached sheet.
§ Marital Status: r Single r Married r Divorced r Widowed
Spouse’s Name:
Spouse’s Address:
Telephone:
Indicate whether your spouse is or has been involved in your ministry; if so, in what capacity?
§ Children: Please list the names and ages of all your children.
Age
Age
Age
Age
If you have been divorced, please provide the place and date of the decree.
Mount Olive Missionary Baptist Church Application Form
SECTION II – EDUCATIONAL BACKGROUND AND TRAINING
High School: Year Graduated:
Address:
College/University ______
Address:
Major: Date Degree Conferred:
College/University
Address:
Major: Date Degree Conferred:
Graduate School:
Address:
Major: Date Degree Conferred:
Graduate School:
Address:
Major: Date Degree Conferred:
Honorary Degrees
Address:
Major: Date Degree Conferred: ______
Continuing Education Courses relevant to this position:
Studies in progress:
Institution:
Address:
Major: Hours Completed: Year Degree Expected:
Mount Olive Missionary Baptist Church Application Form
If you answer “Yes” to any of the questions in the following section, please explain on the attached sheet the nature of the suit, offense, date, court and disposition or other appropriate explanation. A conviction record will not automatically be a bar to employment. Factors such as your age at the time of the crime, seriousness and nature of the violation, time elapsed since the crime, job relatedness, and subsequent rehabilitation will be considered.
1. Are you presently being investigated or under a procedure to consider your discharge for misconduct by your present employer? r Yes r No
2. Has any employer ever subjected you to disciplinary action, suspended, terminated or asked you to leave a job or volunteer position on the grounds of and unlawful sexual behavior, or violation of and employer’s sexual misconduct or harassment policy? r Yes r No
3. Have you ever been charged, found guilty or of found involved in civil or criminal proceedings with improprieties regarding children? r Yes r No
4. Have you ever entered a plea of guilty, a plea of “no contest” or has any court ever deferred further proceedings without entering a finding of guilt and placed you on probation or in a community service or education program for any crime other than a minor traffic offense? r Yes r No
5. Have you ever been suspended, discharged, or resigned in lieu of discharging from any position? r Yes r No
SECTION III – PREVIOUS PASTORAL EXPERIENCES
Please provide previous pastoral and Christian Service experiences (both paid and unpaid), and discuss the following (do not send job descriptions):
1. Church/organization’s name and address
2. Title of position
3. Duties
4. Starting and ending dates (month/year)
5. Hours worked per week
6. Annual salary (paid and/or unpaid)
7. Number of people supervised and nature of their duties
8. Most significant contribution(s)
9. Program(s) implemented that resulted in church growth and an increase in finances
10. Dates and places of revivals, evangelistic crusades, and/or Christian workshops conducted
11. Reason for leaving
Mount Olive Missionary Baptist Church Application Form
SECTION IV – OTHER EMPLOYMENT HISTORY (NON-PASTORAL)
Please provide the following information for paid and unpaid work experience, including military experience, if any (do not send job descriptions):
1. Employer’s name and address
2. Job title
3. Major duties and accomplishments
4. Supervisor’s name, title and phone number
5. Starting and ending dates (month/year)
6. Hours worked per week
7. Annual salary (paid and/or unpaid)
8. Number of people supervised and the nature of their duties
9. Reason for leaving
SECTION V – WRITTEN NARRATIVE
Please provide a statement to express your views on the following:
- The Bible gives the fundamental qualities of a Pastor. Explain how you meet the qualifications for a Pastor as stated in Titus 1:5-9, 1 Peter 5:1-4, and 2 Peter 1:3-11.
- Identify and discuss your personal Christian experience(s) that you view as having been especially important in the development of your Christian faith and life.
- What are your views on the authority relationship that should exist between the Pastor and the Church’s governing boards?
- Describe your specific involvement or experience with Youth Ministries and Sunday School development.
- What is your style of leadership? How do you work with staff, officers, boards, and committees?
- Describe one program, which you implemented that resulted in growth in the youth and young adult populations.
SECTION VI – REFERENCES
Please provide the names, addresses, and telephone numbers of at least three (3) references. At least two references should be in ministry.
Mount Olive Missionary Baptist Church Application Form
Ministerial Experience: Please list your ministry experience for the past five (5) years beginning with your most recent position held. Attach additional sheets if necessary.
MINISTERIAL EXPERIENCEEmployer/Church: / Supervisor:
Address:
Phone # / Dates
From: To:
Job Title
Reason for leaving (be specific)
May we contact this employer for a reference? r Yes r NoEmployer/Church: / Supervisor:
Address:
Phone # / Dates
From: To:
Job Title
Reason for leaving (be specific)
May we contact this employer for a reference? r Yes r NoMount Olive Missionary Baptist Church Application Form
Work Experience: Please list your work experience for the past five (5) years beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets if necessary.
WORK EXPERIENCEEmployer/Church: / Supervisor:
Address:
Phone # / Employment Dates
From: To:
Job Title
Reason for leaving (be specific)
May we contact this employer for a reference? r Yes r NoEmployer/Church: / Supervisor:
Address:
Phone # / Employment Dates
From: To:
Job Title
Reason for leaving (be specific)
May we contact this employer for a reference? r Yes r NoWhat evidence is there that you are able to operate cross-culturally and be at home in a multicultural community? What experience have you had in a multicultural community?
______
Mount Olive Missionary Baptist Church Application Form
LEADERSHIP ROLESWhat are your strengths as a leader?
What evidence exists to confirm the strengths that you have delineated?
What are your weaknesses as a leader?
Discuss three (3) goals or objectives you would like to accomplish in your first year as a pastor of Mount Olive Missionary Baptist Church.
Do you use social media outlets for communications? r Yes r No
If so, please list the social media networks you use (i.e., Facebook, Twitter,) include screen names, hashtags, and affiliations:
Mount Olive Missionary Baptist Church Application Form
PROFESSIONAL, PERSONAL, AND SPIRTUAL REFERENCESList references that are qualified to speak to your spiritual experience and Christian service.
Name/Complete Address Telephone Position
1.2.
3.
4.
5.
Mount Olive Missionary Baptist Church Application Form
SECTION VII – SIGNED AUTHORIZATION
Please read carefully prior to affixing signature. Read carefully, initial each paragraph and sign below.
______initials / I certify that all information in this application is accurate and complete to the best of my knowledge and I have not knowingly withheld any information that might adversely affect my chances for employment. I understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment.
______
initials / I understand that I consent to submit to a criminal records check and or background check by the appropriate investigating authorities.
Please sign the following authorization, which states:
I hereby give the Pulpit Search Committee of Mount Olive Missionary Baptist Church permission to contact my references and to verify any and all information provided in this application and to further investigate my background as it is deemed appropriate.
Printed Name
Signature Date
ADDITIONAL ANSWER PAGES
(Please make reference to the page and questions)
1. ______
2. ______
3. ______
Mount Olive Missionary Baptist Church Application Form
ADDITIONAL ANSWER PAGES
(Please make reference to the page and questions)
4. ______
5. ______
6. ______
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