Page 43 - Set Apart Ministry 2017
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LICENSED MINISTER INTERVIEW GUIDE


                                                                             Date ____________________
               Personal Data

               Name _____________________________________     U.S. Citizen ____Yes  ____ No
                            Last                            First                          Middle                      (If No, please provide INS status)

               Address _______________________________________________________________
                                Street                                                         City                                       State             Zip

               Day telephone ____________________  Evening Telephone _____________________

               E-mail __________________________  Cell Phone ____________________________

               I am currently a member of the ____________________________ congregation, in the

               ________________________________ District.   I have been a member since ______.

               Date of birth:  Month __________  Day _______  Year __________

               Marital status  ____Single  ____Married  ____Widowed  ____Divorced  ____Remarried

               If married, spouse’s name _____________________________________

               Please list any children
               __________________________________   __________________________________
               Name                                                   Age            Name                                                  Age

               __________________________________   __________________________________
               Name                                                   Age            Name                                                  Age

               __________________________________   __________________________________
               Name                                                   Age            Name                                                  Age

               __________________________________   __________________________________
               Name                                                   Age            Name                                                  Age

               What is your present occupation?
               ______________________________________________________________________

               ______________________________________________________________________





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