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Personal & Family

Date*

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Last Name*

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First Name*

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Middle Name

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Email Address*

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Address*

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City*

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State*

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Zip Code*

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Are You*

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Age Of Applicant*

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Age Of Spouse*

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Number of children at home and ages*

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What is the status of your health at this time? Explain Fully.*

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What is the status of your spouse's health at this time? Explain Fully.*

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What is the status of your children's health at this time? Explain Fully.*

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Do you have any other dependents? If so please explain.*

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Do you have the full support of your family in this move?*

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Personal Education

Name of High School*

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High School City*

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Did You Graduate

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Year Graduated*

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Name Of College

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Did You Graduate

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Year Graduated

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Name Of Bible College

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Did You Graduate

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Year Graduated

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Personal Finances

Do you have any church construction experience?*

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If so explain

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Are you experienced in any kind of secular work?

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If yes Explain

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What secular job do you now hold?

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Does your spouse have a secular job? if yes expalin.

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Total Current Monthly Income. Please include all sourses of income from ministry, secular work, spouse's secular work, investment income, etc.

From SECUALR WORK

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From THE MINISTRY

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Other INCOME (Include All)

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Total Income

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What is your TOTAL current MONTHLY EXPENSES? (Please include ALL expenses.)

Monthly Automobile Payment(s)

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Monthly Automobile Insurance

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Monthly Automobile Expenses

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Home Mortgage/Rent

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Home Insurance

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Monthly Average Utilities Combined

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Monthly Cell and Phone Expense

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Monthly Medical Bills & Health Insurance

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Total Credit Card Payments

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Personal Loan Payments

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Real Estate (other than home)

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Groceries

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Clothing (& other family expenses)

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Other Debts and Payments ( all other payments, including child support, back taxes or any other outgoing expenses.)

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Total Monthly Expenses

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Total Net Monthly Income

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Are you current repaying your debts? If NO explain.

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Have you ever declared BANKRUPTCY? If YES explain and state year filed.

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What is the total number of Credit Cards in your name?

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What is the total owed on all credit cards?*

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What is the total number of Personal Loans in your name?

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What is the total amount owed to personal loans?

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I authorize the LA District UPC to request a credit reference check on my name if deemed necessary. *

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Social Security Number

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Personal Cooperation

Have you cooperated with the financial plan (tithing, etc.) of your district? If NO, please explain:

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Did you PERSONALLY support CHRISTMAS FOR CHRIST last year?*

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If YES, what was the amount?

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How much are you PERSONALLY GIVING to the following programs?

North American Missions (Monthly Amount)

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Foreign Missions (Monthly amount)

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Move The Mission (Yearly Offering)

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Will you cooperate with the Louisiana District?

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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.)

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Personal Doctrine

What do you preach to be the essentials as the Bible requirements of salvation?*

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How do you interpret the Bible requirement of holiness?

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What is your approach in presenting holiness to new converts?*

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Do you have a television?*

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What are your convictions concerning television?

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Personal Ministry

Where did you receive the Holy Ghost?

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What year did you receive the Holy Ghost?

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What is your present ministry status?

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If other, please describe:

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If a FULL TIME PASTOR, how long? (Years)

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If a FULL TIME EVAGELIST, how long? (Years)

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How long have you been in the ministry? (Years)

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What type of license do you hold?

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What year was your license issued

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Current Pastor Name

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Current Pastor Address, City, State and ZIp:

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Current Pastor Phone Number

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Please list all FORMER PASTORS: (Name City Phone)

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If Currently Pastoring, what is the name, city and state of your current church?

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When was the church started?

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How long have you been at the PRESENT field of labor?

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How much growth has the church experienced NUMERICALLY under YOUR MINISTRY?

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How many souls have YOU won during the past two years OUTSIDE the pulpit (through personal Home Bible studies, etc.)?

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Target City

In what city do you desire Appointment to start a new work?*

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Area*

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Population Of City*

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How did you arrive at the feeling that this was the city for you?*

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Why are you interested in this city?*

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Do you know any Pentecostal people in the city?

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Is this a growing area? Please Describe.*

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If you receive Home Missionary appointment, will you aggressively evangelize your city to the best of your ability?*

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What is your basic approach in soul-winning?*

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What is the minimum length of years you feel a minister should stay with a new church plant before moving to another work?*

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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?*

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What is the name of the NEAREST UNITED PENTECOSTAL CHURCH to the projected CHURCH PLANT?

Church Name

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City*

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Pastor*

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Distance in miles from projected church plant:*

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If your application is NOT approved, what are your immediate plans?*

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References

Present or Former Pastor

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District Superintendent (Present or Former)

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Presbyter (Present or Former)

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Former Teacher in Bible College (if applicable)

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Fellow Student in Bible College who is now in the ministry (if applicable)

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Businessman or Employer (Present or Former)

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Minister Friend

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Minister Friend

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Minister Friend

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Minister Friend

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PLEASE READ CAREFULLY BEFORE SIGNING THE APPLICATION

I have answered the preceding questions to the best of my knowledge and understanding. If I am chosen as a Louisiana North American Missionary, I pledge to cooperate with the Louisiana District UPC in every possible way.

Signature of Applicant _____________________________________ Date _________________

Signature of Spouse ______________________________________ Date __________________

Please upload a picture of your entire family.

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Here you can include anything you feel is important to express your burden more fully.

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Personal & Family

Personal Education

Personal Finances

Total Current Monthly Income. Please include all sourses of income from ministry, secular work, spouse's secular work, investment income, etc.

What is your TOTAL current MONTHLY EXPENSES? (Please include ALL expenses.)

Personal Cooperation

Personal Doctrine

Personal Ministry

Target City

References