2011-2012 Ministerial Questionnaire

RETURN OF THIS QUESTIONNAIRE IS REQUIRED FOR RENEWAL OF MINISTERIAL LICENSE AND CONFERENCE CARE MEMBERSHIP AND ALSO AFFECTS THE CONTINUED GOOD STANDING OF ALL MINISTERIAL MEMBERS PLEASE RETURN AS SOON AS POSSIBLE, BUT NO LATER THAN DECEMBER 31, 2011

Name
FirstLast
Home Address
Street AddressCityStateZip Code
Mailing Address
Street AddressCityStateZip Code
Phone
Email
Birthdate
Spouse's Name
Your Present CCCC Standing
- Ordained
- Associate
- Licensed
- Lay Preacher
- Comissioned CW
- Conference Care
Are you still employed in the same or another similar ministry in which your present ministerial standing is needed?
- Yes
- No
Is there anything we need to know that might affect your current credentials status with us (e.g. marital, church, personal troubles, or changes in doctrinal position)? Please explain.
Of what local church are you a member?
Is it congregationally governed?
- Yes
- No
Have you ever attended a CCCC Annual Meeting?
- Yes
- No
What have you done in the area of continuing education this past year, either formally or informally? Please explain.
Are there CCCC regional activities in your area of the country?
- Yes
- No
If yes, please list those you have been able to attend, as well as any other CCCC related activities.
On what committee(s) of the Conference would you be interested in serving (see pgs 8-13, 2011 Yearbook)? If you know a lay person who would be interested in serving on a CCCC committee email Carlton Walker at ckwalker3@verizon.net.
Your Christian Service (for the 2012 yearbook)
- Full Time
- Part Time
- Retired
Place of service
Position or responsibility
Address
Street AddressCityStateZip Code
Phone
Fax
Denominational affiliation of present place of service
Date you began at your present place of service
Regarding Placement
Are you actively seeking a change in ministry at this time?
- Yes
- No
Is it likely you might be seeking a change in ministry in the next year?
- Yes
- No
Check if you need a pastoral placement form
- Yes, I need a pastoral placement form.
Are you interested in church planting and participating in a church planter’s assessment?
- Yes
- No
Ordained Ministers And Commissioned Christian Workers
Do you still desire to retain your ministerial credentials with the CCCC?
- Yes
- No
(If you check no, please fully explain your reasons below.)
Licensed Ministers
Do you hereby request the renewal of your license for another year?
- Yes
- No
What steps have you taken this year in preparation for ordination?
Ordained Licensed Ministers
Do you hereby request that your standing be changed to regular ordained standing?
- Yes
- No
If so, please indicate the extent to which you have been involved in CCCC activities.
Lay Preachers
Do you hereby request the renewal of your standing for another year?
- Yes
- No
(Note: Renewal will be dependent on your home church's continued affirmation of your standing.)
Students Under Conference Care
What school are you attending?
When do you expect to graduate?
Please write a brief report of your academic and practical progress in preparation for ministry.
Missionaries
Where are you presently serving?
With what organization(s) are you now serving?
What are you lacking in your financial support? (monthly)
What CCCC member churches now contribute to your prayer and financial support?
What is your furlough schedule?
What will be your furlough address?
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
PERSONAL AFFIRMATIONS (Please check each of the statements below to affirm your agreement):
*
- I affirm that I remain in firm agreement with the CCCC Statement of Faith (2011 CCCC Yearbook, page 129)
*
- I affirm that I remain committed to the principles of the CCCC Statement of Polity (2011 Yearbook, page 129)
*
- I affirm that with the help of Almighty God I will seek to live my life of Christian ministry in accordance with the CCCC Code of Ethics for Ministers (2011 Yearbook, page 147)

2011-2012 Ministerial Questionnaire

Your Present CCCC Standing

Your Christian Service (for the 2012 yearbook)

Regarding Placement

Ordained Ministers And Commissioned Christian Workers

Licensed Ministers

Ordained Licensed Ministers

Lay Preachers

Students Under Conference Care

Missionaries

PERSONAL AFFIRMATIONS (Please check each of the statements below to affirm your agreement):

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