BOARD OF ORDAINED MINISTRY CALIFORNIA-PACIFIC ANNUAL CONFERENCE THE UNITED METHODIST CHURCH
PROVISIONAL MEMBERSHIP APPLICATION Application Deadline: October 1st until 11:59:59 P.M. (PST) (Of the Year Prior to the Commissioning Year)
The form must be completely filled out electronically in PDF format with a digital signature. No scanned, handwritten, or faxed forms accepted. The application will not be accepted if there is missing information.
*IMPORTANT NOTICE: Applicants for provisional membership must have attended the ‘Orientation to Ministry’ prior to submitting the application. This is the Book of Discipline requirement (¶ 312). If the applicant has not attended the 'Orientation to Ministry' by October 1 of the year prior to the commissioning year, the application cannot be processed. The Candidacy Summit fulfills the 'Orientation to Ministry' requirement. The information on the upcoming Candidacy Summit can be found on the Board of Ordained Ministry website – www.calpacumc.org/bom.
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Name of Applicant: _____________________________________________________________________ First (Given) Middle Last (Family) *Please provide your official name with its precise spelling and arrangement. Include spaces and diacritical marks where necessary. Being fully persuaded that God has called me to be a minister of the gospel of the Lord Jesus Christ, I hereby request affirmation of that call by the United Methodist Church through the granting of a clergy relationship to the Annual Conference. The relationship for which I am applying is (indicate only one): ___ Commissioning as a Deacon
___ Commissioning as an Elder
Have you been recommended by your District Committee on Ordained Ministry to be eligible for commissioning at 2017 Annual Conference? (¶ 324.10, The Book of Discipline)? ___ Yes ___ No •
If YES, provide the date and then proceed with filling out the application form. No application for commissioning will be accepted if the applicant has not been recommended by his/her District Committee on Ordained Ministry (dCOM) in 2016-2017 annual conference year.
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Date of the Recommendation by Your dCOM: ________________________________________________
BACKGROUND INFORMATION: Primary E-Mail: ________________________________ Primary Telephone: _______________________ Preferred Mailing Address: ___ Home
___ School
___ Worksite
Number and Street: ______________________________________________________________ City ________________________________________ State __________ Zip ________________ Birth Date: (MM/DD/YYYY) __________________ Age: _____ Ethnicity:
Gender: ___
Female
___ African
___ Asian
___ European ___ Hispanic
___ Native American
___ Pacific Islander
___ Other
___ Male
Country of Birth: _____________________________ Birthplace: ________________________________ Languages you speak: With fluency? ______________________ Without fluency? ______________________________
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Are you a citizen of the United States? ___ Yes ___ No • If NO, what documentation do you have to prove you are legally residing in the United States? ______________________________________________________________________________ Please provide a photocopy of documentation with this application. All non-citizen candidates will need to have their R-1 or Permanent Residency by the time of Commissioning. Marital Status: ___ Single, never married
___ Married, in first marriage
___ Married, in second or more
___ Widowed
___ Separated
___ Divorced
If Engaged, Fiancé’s Name: _________________________________ Birth Date: ___________________ If Married, Spouse’s Name: __________________________________ Birth Date: ___________________ Date of Marriage: _______________________________ Spouse’s Occupation: _____________________ Your Children (If Any): If none, write “None.”
Name
Date of Birth
Gender
Education
Dependents in Addition to Your Spouse and Children: If none, write “None.”
Name
Date of Birth
Gender
Education
Your Childhood Family and Other Significant Relatives:
Name
Relation
Age
Gender
Education
Occupation
Your work experiences, such as current and previous employment, and military experiences, if any: __________________________________________________________________________________ __________________________________________________________________________________
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List other vocational fields you have followed or considered. If none, write “None.”: __________________________________________________________________________________
Have you ever been convicted of a felony? ___ Yes ___ No • If YES, please attach a document in a Word (.doc) file, providing information.
Indicate handicaps, limitations, or illnesses that might affect your work. If none, write “None.” __________________________________________________________________________________
What kind of appointment in ordained Christian ministry is of primary interest to you currently? ___ Local Church
___ Chaplaincy
___ Education
___ Urban Ministry
___ Missionary
___ Evangelist
___ Counseling
___ Other (explain below)
__________________________________________________________________________________
Briefly describe your involvement in your local church, such as your leadership positions, groups you enjoy, church activities, etc.: __________________________________________________________ __________________________________________________________________________________
As a provisional member, are you willing to serve under the jurisdiction and the supervision of the California-Pacific Annual Conference? ___ Yes ___ No If NO, please explain: _______________________________________________________________ __________________________________________________________________________________
Your Educational Background: (List all undergraduate and graduate education): Institution High School
Name
Dates Attended
Degree Granted/Major
College Graduate School Theological Seminary
Are you currently enrolled in seminary? ___ Yes ___ No If YES, provide the expected graduation date: __________________
*If you are applying for the Elder track and do not have a M.Div., you must submit a verification of transcripts from the General Board of Higher Education & Ministry (GBHEM) that shows your graduate course being equivalent to a M.Div. Without this verification, the application will not be accepted. The verification must be submitted with this application by October 1st until 11:59:59 P.M. (PST).
Are you applying for provisional membership through the Local Pastor route? ___ Yes
___ No
•
If YES, have you completed the five-year Course of Study for ordained ministry? ___ Yes ___ No
•
If YES, Have you completed an Advanced Course of Study? ___ Yes ___ No
*When submitting this application, please attach your certificates to verify that you have completed the above courses.
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Required Basic Graduate Theological Studies: (Provide one class name per course. Make sure that the class name is exactly the same as it is listed in the official transcript.) Required Course
Name of the Class
Name of the Institution
Date Taken/ To be Taken
Theology Worship/Liturgy Evangelism Old Testament New Testament Church History Mission of the Church in the World United Methodist Doctrine United Methodist Polity United Methodist History According to Board policy, the basic graduate theological studies must be completed prior to June of the year of Commissioning.
Seminary -supervised field work in a ministry setting: ___ Yes
___ No
Dates: Beginning: _____________________________ Concluding: ___________________________ Site of Field Work: __________________________________________________________________
CANDIDACY INFORMATION:
Home Church: ______________________________ Home District: ___________________________
Have you attended an ‘Orientation to Ministry’ (¶ 312, The Book of Discipline) or the Candidacy Summit held by the Conference Board of Ordained Ministry? ___ Yes ___ No Date _____________________ Location ________________________________________________
*Applicants for provisional membership must have attended the ‘Orientation to Ministry’ prior to submitting the application. If the applicant has not attended the 'Orientation to Ministry' by October 1 of the year prior to the commissioning year, the application cannot be processed.
Certification as a Candidate for Ordained Ministry: Date _____________________ District __________________________________________________
Transfer of candidacy to a different District since becoming a certified candidate? ___ Yes
___ No
Date _____________________ District __________________________________________________
Tier I Date _______________________________ Tier II Date _______________________________
*According to the Board’s psychological testing policy, there needs to be at least a year between the Tier I and Tier II. Your application will not be approved if those dates are less than twelve months from each other. However if your tests were done prior to the rule change (before July 2013), you’ll be eligible to apply for commissioning. Also, Tier II tests need to be completed before the District Committee on Ordained Ministry’s recommendation meeting in September. Please schedule your tests ASAP. If your Tier II results are more than five years old by the time of the dCOM interview, please contact the counseling center to schedule a new assessment.
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CONFERENCE RELATIONSHIP:
License as a Local Pastor: ___ Yes
___ No
If YES, Date __________________ Conference ______________ District __________________ Appointments as a Licensed Local Pastor: ___ Yes
___ No
Date _________________________ Church __________________________________________ Date _________________________ Church __________________________________________ Provisional Membership: ___ Yes
___ No
If YES, Date ___________________________ Conference _______________________________ Membership in Full Connection: ___ Yes
___ No
If YES, Date ___________________________ Conference _______________________________ Other (specify) If none, write “None.” _____________________________________________________
CHANGE IN CONFERENCE RELATIONSHIP: (Check all that apply.) ___ Applicable ___ Not Applicable ___ Administrative Location
___ Discontinuance
___ Disability Leave
___ Honorable Location
___ Retirement
___ Surrender of Ordained Ministerial Office
___ Termination by Action of the Annual Conference
___ Withdrawal to Unite with Another Denomination
___ Withdrawal under Complaints and Charges
___ Other
If Applicable, Date ___________________________ Conference _______________________________ Explain: _____________________________________________________________________________ Give dates and names of membership in any denomination other than the United Methodist Church: Denomination Start Date of Membership End Date of Membership
Have you previously applied for membership to an Annual Conference of the United Methodist Church, including California-Pacific Conference? ___ Yes ___ No Please provide the name of the conference(s) and date(s) of application. If none, write “None.” Conference
Year(s) of Application
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PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY AND DIGITALLY SIGN BELOW, INDICATING THAT YOU HAVE READ AND UNDERSTAND THESE STATEMENTS:
I understand that, if at any time in the process, it is determined that I am not eligible to apply for or to become a Provisional Member, I will be returned to the care of my District Committee and continued in Certified Candidacy status.
I understand that, if any deadline is not met, I will be withdrawn from the application process and returned to the care of my District Committee and continued in Certified Candidacy status.
I understand that it is the practice of the Board of Ordained Ministry to share interview results and recommendations with the District Committee Chairperson and District Superintendent (in the event that candidacy is continued) or with the Candidacy/Clergy Mentor.
I understand that if I am not a citizen of the United States and do not have the proper immigrant status, I will not be able to be commissioned.
I understand that, if I am unwilling to serve under the jurisdiction and the supervision of the United Methodist Church as a Provisional Member, I will be withdrawn from the application process and returned to the care of my District Committee and continued in Certified Candidacy status.
I understand that all the materials submitted to the Board shall be genuinely of my own work and that all sources used in my exam papers shall be properly cited. I have read the policy on plagiarism and understand the consequences of improper citation.
If I have any questions pertaining to the process or requirements, I will contact the Assistant Registrar for Provisional Membership (Provisional Registrar).
Signed: ________________________________________________ Date: _______________________ *You must provide a full face (HEADSHOT) digital photo of yourself along with this application. Please submit a JPEG file in high resolution of at least 1920 x 1080 (1080 x 1920) pixels. This photo will be used during the Clergy Session at Annual Conference should you get recommended by the Board of Ordained Ministry to be commissioned. A small resolution photo will result in displaying a grainy and distorted photo on the Annual Conference screen, which prevents the best presentation of the candidate. The Board of Ordained Ministry would like for you to make a great first impression to the Clergy Session. Also, please make sure that you are NOT wearing a stole in the picture. A stole is designated for those who are already fully ordained. This application will not be accepted if you fail to submit a photo in the specified format. E-mail a PDF file of this application, your digital photo, and required documents to: Ms. Cathy Wilson, Administrative Coordinator,
[email protected] and Rev. Sunyoung Lee, Provisional Registrar,
[email protected] Keep a copy of all forms, correspondence, and papers that you submit for your files. Please address questions about the application process to Rev. Sunyoung Lee.
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