Louisiana District. North American Missions Application
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1 Louisiana District North American Missions Application 1
2 LOUISIANA DISTRICT NAM APPLICATION Please Print (or type) Enclose (or ) a Photo of You and Your Family Date_ What is the city/town/village in which you are interested in starting a church? Population: City Area 1. Your Name: First Last Middle 2. Present Address: City: State: Zip Code: 3. Telephone: HOME CELL ADDRESS PERSONAL - FAMILY 4. Are you: Married Single Divorced Widowed 5. Age of applicants: Husband Spouse Spouse s Name 6. Number of children living AT HOME: (Ages,,, ) 7. What is the status of YOUR HEALTH at this time? (Explain fully) 8. What is the status of YOUR SPOUSE S HEALTH at this time? (Explain fully) 9. What is the status of your CHILDREN S HEALTH at this time? (Explain fully) 2
3 10. Do you have any other dependents? If so, please describe 11. Do you have the full support of your family in this move? If NO, please explain PERSONAL - EDUCATION 12. Name of High School City Did you graduate? Year you graduated? 13. Name of College City Did you graduate? Year you graduated? 14. Name of Bible School Did you graduate? Year you graduated? PERSONAL - FINANCES 15. Do you have any church construction experience? If yes, describe: 16. Are you experienced in any kind of secular work? If yes, describe: 17. What secular job do you now hold? 18. Does your spouse have a secular job? If yes, please describe: 19. What is your TOTAL current MONTHLY INCOME? (Please include all sources of income from the ministry, secular work, spouse=s secular work, investment income, etc.) From SECULAR WORK $ From the MINISTRY $ OTHER (Include all) $ 20. What is your TOTAL current MONTHLY EXPENSES? (Please include ALL expenses.) 3
4 Description: Monthly Amount Automobile Payment(s) $ Automobile Insurance Automobile Expenses Home Mortgage (rent) Average Utilities Combined Telephone Furniture Payments Home Insurance Medical Bills Credit Card Payments Personal Loan Payments Real Estate (other than home) Groceries Clothing (and other family expenses) Other Debts and Payments TOTAL MONTHLY PAYMENTS $ 21. Are you current in repaying your debts? If No, explain: 22. Have you ever declared BANKRUPTCY? If Yes, explain: 23. What is the total number of credit or charge card accounts in your name? (a) What is the total amount owed on all credit or charge accounts? $ (b) What is the total monthly payment on your card accounts? $ 24. What is the total number of Personal Loans in your name? (a) What is the total amount owed to personal loans? _ (b) What is the total monthly payments made for personal loans? $ 25. I authorize the Louisiana District UPC to request a credit reference check on my name if deemed necessary. 4
5 Signature Social Security Number Date PERSONAL - DOCTRINE 26. What do you preach to be the essentials as the Bible requirements of salvation? 27. How do you interpret the Bible requirement of holiness? _ 28. What is your approach in presenting holiness to new converts? 29. Do you have a television? 30. What are your convictions concerning television? PERSONAL - COOPERATION 31. Have you cooperated with the financial plan (tithing, etc.) of your district? If NO, please explain: 32. Did you PERSONALLY support CHRISTMAS FOR CHRIST last year? If YES, what was the amount? $ 33. How much are you PERSONALLY GIVING to the following programs? Home Missions (Monthly amount) $ Foreign Missions (Monthly amount) $ Sheaves for Christ (Yearly) $ 34. Will you cooperate with the Louisiana District? 35. Will you affiliate your assembly with the United Pentecostal Church? (PLEASE NOTE: IF ANY MONEY is granted, it is REQUIRED that the church be AFFILIATED.) PERSONAL - MINISTRY 36. Where did you receive the Holy Ghost? Place: Year: 37. What is your present ministry status? Pastor Assistant Evangelist If other, please describe: If a FULL TIME PASTOR, how long? Years If a FULL TIME EVAGELIST, how long? Years 38. How long have you been in the ministry? Years 5
6 39. What type of license do you hold? LOCAL Date issued GENERAL Date issued ORDAINED Date issued 40. Present Pastor: Name Address City, St ZIP Telephone 41. Please list all FORMER PASTORS: Name City Telephone 42. If PASTORING, where is your PRESENT field of labor? Name of Church City State (a) When was the church started? Date: (b) How long have you been at the PRESENT field of labor? Years Months (c) How much growth has the church experienced NUMERICALLY under YOUR MINISTRY? Began with members, presently have members. 43. How many souls have YOU won during the past two years OUTSIDE the pulpit (through personal Home Bible studies, etc.)? TARGET CITY 44. How did you arrive at the feeling that this was the city for you? 45. Why are you interested in this city? 46. Do you know any Pentecostal people in the city? 6
7 47. Is this a growing area? Please describe: 48. If you receive Home Missionary appointment, will you aggressively evangelize your city to the best of your ability? (a) What is your basic approach in soulwinning? 49. What is the minimum length of years you feel a minister should stay with a new church plant before moving to another work? Years. 50. If approved, are you willing to make a commitment to the Louisiana District UPC to stay with the church plant the same number of years? If yes, initial here 51. What is the name of the NEAREST UNITED PENTECOSTAL CHURCH to the projected CHURCH PLANT? Name of church: City: Pastor: Distance from you: Miles 52. If your application is NOT approved, what are your immediate plans? 53. What will be the name of your new church is you are approved? REFERENCES Please give the name and complete mailing addresses for the persons requested below: Present or Former Pastor 7
8 District Superintendent (Present or Former) Presbyter (Present or Former) Former Teacher in Bible College (if applicable) Fellow Student in Bible College who is now in the ministry (if applicable) Businessman or Employer (Present or Former) PLEASE READ CAREFULLY THEN SIGN THE APPLICATION 8
9 I have answered the preceding questions to the best of my knowledge and understanding. If I am chosen as a Louisiana Home Missionary, I pledge to cooperate with the Louisiana District UPC in every possible way. Signature of Applicant Date Signature of Spouse Date NOTE: When submitting this application, please include a personal note or letter covering anything you feel is important to express your burden more fully. Enclose or ( ) a Photo of You and Your Family Please send the completed application: to: derald_r_weber@aol.com Or Mail to: LA District NAM Attn: Rev. Derald Weber P. O. Box Lafayette, LA If you have questions please call Rev. Derald Weber at
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