8941 33rd St North, Lake Elmo, MN 55042 | 651-739-1474 | [email protected]| www.ccccusa.com Date: PASTOR INFORMATION FORM Please fill in the following information GENERAL INFORMATION: Name: Address: City: State: Zip: Home Phone: ( ) Office Phone: ( ) E-mail: Date of Birth: Place of Birth: Citizenship: Marital Status: ! Single ! Married ! Divorced ! Remarried ! Widowed Spouse’s Name: Date of Birth: Date of Marriage: Spouse’s specialized training: Do you expect your spouse to work outside the home? ! Yes ! No Children: Names Ages Gender Other Dependents: Health considerations for you or your family you wish the congregation to be aware of: Page 1 of 5 pages
Transcript
8941 33rd St North, Lake Elmo, MN 55042 | 651-739-1474 | [email protected] | www.ccccusa.com
Date:
PASTOR INFORMATION FORM Please fill in the following information
GENERAL INFORMATION: Name:
Address:
City: State: Zip:
Home Phone: ( ) Office Phone: ( )
E-mail:
Date of Birth: Place of Birth: Citizenship:
Marital Status: ! Single ! Married ! Divorced ! Remarried ! Widowed Spouse’s Name: Date of Birth: Date of Marriage:
Spouse’s specialized training: Do you expect your spouse to work outside the home? ! Yes ! No Children: Names Ages Gender Other Dependents: Health considerations for you or your family you wish the congregation to be aware of:
Page 1 of 5 pages
Pastor Information Form— (cont.)
Pastor Information Form— (cont.)
8941 33rd St North, Lake Elmo, MN 55042 | 651-739-1474 | [email protected] | www.ccccusa.com Revised 11-2015
Conservative Congregational Christian Conference
EDUCATION: College:
Degree: Date of Graduation:
Major: Minor:
Seminary:
Degree: Date of Graduation:
Major: Minor:
Other Graduate Study:
Continuing Education: (workshops, seminars, etc.)
Specialized Training:
PROFESSIONAL INFORMATION: Present Position: ! Senior Pastor ! Associate Pastor ! Assistant Pastor ! Youth Pastor ! Director of Christian Education ! Other: (please specify) Church or Institution of Present Position: Name:
Address:
City: State: Zip:
Phone: ( ) Website:
E-mail:
Page 2 of 5 pages
Pastor Information Form— (cont.)
8941 33rd St North, Lake Elmo, MN 55042 | 651-739-1474 | [email protected] | www.ccccusa.com Revised 11-2015
Conservative Congregational Christian Conference
PROFESSIONAL INFORMATION: (cont)
Of what church(es) are you a member?
Date of Ordination: Church or denomination ordained by?
Date of License: (if not ordained) Church or denomination licensed by?
Where is your present ministerial standing?
Have you attended a CCCC Annual Gathering? ! Yes ! No
MINISTRY EXPERIENCE: List the last four positions only.
Please include: position/title; church name, address, phone; size; dates of tenure; full/part-time; reason for leaving 1. 2. 3. 4. In present/most recent ministry position what is the church’s:
a. Membership: b. Sunday School attendance:
c. Average attendance: d. Total budget:
Page 3 of 5 pages
Pastor Information Form— (cont.)
8941 33rd St North, Lake Elmo, MN 55042 | 651-739-1474 | [email protected] | www.ccccusa.com Revised 11-2015
Conservative Congregational Christian Conference
TOTAL YEARS OF PASTORAL MINISTRY: (Enter number of years) Senior pastor Minister of Visitation Minister of Counseling Solo pastor Minister of Evangelism Youth minister Assistant pastor Minister of Music/Worship Military chaplain Minister of Christian Ed Minister of Missions Institutional chaplain Parachurch ministry Other: (please specify) TOTAL YEARS of Pastoral Experience Other work experience contributing to effective ministry:
What activities are you involved in beyond the local church?
THEOLOGICAL INFORMATION: The churches of the Conservative Congregational Christian Conference represent a cross section of the Evangelical community. This section helps make honest matches theologically with the pastor and the church.
1. Check the Evangelical sub-group that describes you: (Check all that apply) ! Fundamentalist ! Dispensational ! Conservative Evangelical ! Reformed ! Wesleyan ! Progressive Evangelical ! Charismatic ! Pentecostal ! Main-line Evangelical 2. Check your Baptismal practices: ! Believer’s Baptism ! Immersion ! Infant Baptism ! Sprinkle/Pour 3. Check your view of the Charismatic/Pentecostal movement: ! Opposed ! Neutral ! Agree with ! Endorse 4. Check your view of women serving as Church Elders or Pastors: ! Approve ! Oppose 5. Which word(s) best describe your style of worship: ! Liturgical ! Traditional ! Contemporary ! Blended 6. Which translation of the Bible do you use most often:
Page 4 of 5 pages
Pastor Information Form— (cont.)
8941 33rd St North, Lake Elmo, MN 55042 | 651-739-1474 | [email protected] | www.ccccusa.com Revised 11-2015
Conservative Congregational Christian Conference
COMMUNITY PREFERENCES: (Mark an “X” for your preferences. Mark an “N” for options you would NOT consider.) Geographic locale: New England (ME, VT, NH, MA, CT, RI) Northeast (NY, NJ, PA) East Central (MD, DE, VA, WV) Southeast (NC, SC, GA, FL) North Central (MI, WI, IA, MN, ND, SD) Midwest (OH, IL, IN, KY, MO, KS, NE) South Central (TN, AL, MS, LA) Northwest (MT, WY, ID, WA, OR, AK) West (CO, NM, AZ, UT, NZ, CA, HI) Southwest (OK, TX, AR)
Community: Rural Suburban Urban (downtown) Small town Urban (residential) Inner city Size of church: under 100 101-250 251-500 501-1000 over 1000 members no preference Type of pastoral position: Senior pastor Solo pastor Associate pastor Church plant
PASTORAL ACTIVITIES: On a scale of 1 to 10, evaluate the characteristics in a pastor that you are seeking. Mark a 10 for the areas of greatest strength and write 1 for the area of least ability. Preaching Teaching Evangelism Discipleship Worship leading Administration Counseling Missions Lay ministry Small groups Christian Ed Visitation Youth work College & Career Seniors Singles Families Children Church Growth Leadership Development
References: (Please list five references ) 1.
2.
3.
4.
5.
The Conservative Congregational Christian Conference provides to churches information about search processes and maintains a list of clergy seeking calls. The Conference also provides information to clergy about church vacancies. The Conference makes no representation as to the fitness of any clergy person or the accuracy of information provided by a congregation. Each clergy person is responsible for evaluating each congregation's appropriateness to his calling. Each congregation is responsible for its’ own hiring process and decision. All terms and conditions of employment are the sole responsibility of the local church. NOTE: Please treat this Pastor Information Form in a confidential manner. We hope you will assist us in avoiding embarrassment to the pastor who submitted this form. The CCCC expects all recipients of the information on this form to preserve its contents with the strictest of confidentiality.
