Online Ministerial Questionnaire

Thank you for filling out the Annual Ministerial Questionnaire.

For your convenience, when you have successfully submitted the form, you will be automatically directed to the CCCC online donations portal. Please note CCCC membership cards will not be issued after January 31st.

Ministerial Questionnaire

To Renew your MINISTERIAL LICENSE or CONFERENCE CARE MEMBERSHIP and to update your MINISTERIAL CREDENTIALS, please fill out this questionnaire. Your assistance to complete this information by December 15th is greatly appreciated. Thank-you!

PERSONAL INFORMATION
Name*
(*Indicates required field)
First Middle Last
Title
Please select one
- Rev Dr
- Rev
- Mr
- Ms
- Mrs
E-mail*
Please provide your preferred email address to receive important CCCC communication and confirmation that this form is completed correctly.
Enter Email Confirm Email
Home Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mailing Address (If DIFFERENT than Home address)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Cell Phone
Spouse's Name
CCCC STANDING
Your Present CCCC Standing
- Ordained
- Licensed
- Associate
- Lay Preacher
- Commissioned Christian Worker
- Conference Care
Are you still employed in the same ministry in which your present ministerial standing is needed?
Are you still employed in the same ministry in which your present ministerial standing is needed?
- Yes
- No
Do you have any personal circumstances that might affect your current CCCC credentials status? (eg. marital, church, personal, or changes in doctrinal position) If so, please explain.
Do you have any personal circumstances that might affect your current CCCC credentials status? (eg. marital, church, personal, or changes in doctrinal position) If so, please explain.
Name of the church where you are a member:
Is the church where you hold your membership congregationally governed?
- Yes
- No
YOUR CHRISTIAN SERVICE
Christian Service
- Full Time
- Part Time
- Retired
- Volunteer
Place of service
Position/Responsibility
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Denominational affiliation of present place of service
Phone
Place of ministry E-mail
Enter Email Confirm Email
Website
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.)
(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
(If you check no, please fully explain your reasons below.)
(If you check no, please fully explain your reasons below.)
Lay Preachers
Do you hereby request the renewal of your standing for another year? (Note: Renewal will be dependent on your home church's continued affirmation of your standing.)
- Yes
- No
(If you check no, please fully explain your reasons below.)
(If you check no, please fully explain your reasons below.)
Students Under Conference Care
Expected graduation date
What school are you attending?
What school are you attending?
Please write a brief report of your academic and practical progress in preparation for ministry.
Please write a brief report of your academic and practical progress in preparation for ministry.
International Workers
Where are you presently serving?
Organization(s) you now serve:
Organization(s) you now serve:
Home Base Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Additional comments:
Additional comments:
STATEMENT OF COMMITTMENT AND AFFIRMATION
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 (pages 103-104, 2021-2022 CCCC Yearbook)
- I affirm that I remain committed to the principles of the CCCC Statement of Polity (page 104, 2021-2022 Yearbook)
- 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 (pages 109-110, 2021-2022 Yearbook)
Phone
This field is for validation purposes and should be left unchanged.

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Ministerial Questionnaire

PERSONAL INFORMATION

CCCC STANDING

YOUR CHRISTIAN SERVICE

STATEMENT OF COMMITTMENT AND AFFIRMATION