Step 1Complete the appropriate sections
Step 2Confirm Information
Step 3Finished
Student First Name
Student Last Name
If the church has not ordained or licensed this student, the statement of certification above must be affirmed by the congregation. This congregational certification has been acted upon by one of the methods below.
Method of Affirmation of Certification Please select... Ordination of Student Licensing of Student Adoption of the statement of certification by congregation Adoption of the statement of certification by others representing the congregation
Date of Ordination of Student
Date of Licensing of Student
Date of Certification by Congregation
Date of Certification by Others
Describe Other Representation
First Name
Last Name
Email
Position at Church
Phone example: 123-456-7890
Please describe the student's character and how he/she has demonstrated a Christian lifestyle
Please describe the student's involvement in church and ministry-related activities
Please describe your impression of the student's sense of calling to vocational Christian ministry
Name of Church
Address
City
State Please select... AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AS FM GU MH MP PW PR VI AE AA AP Other
Zip Code
Baptist Association If this does not apply, state "none"
Association City If this does not apply, state "none"
Association State If this does not apply, state "none" Please select... AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AS FM GU MH MP PW PR VI AE AA AP Other
Baptist State Convention If this does not apply, state "none"
Baptist Affiliations, National If this does not apply, state "none"
Denominational Affiliation If this does not apply, state "none"
Regional Affiliation If this does not apply, state "none"
National Affiliation If this does not apply, state "none"
