Membership Application

Full Name *

Street Name *

Apartment, Suite, etc *

City *

State/Province *

Zip Code *

Country *

E-mail *

Phone *

Date of Birth

Option *

Single

Married

Divorced

Widowed

Have You Been Baptized *

Yes

No

Date of Baptism *

Place of Baptism *

Have You Been Confirmed *

Yes

No

Date of Confirmation *

Bishop/Minister of Confirmation *

Have You Ever Been Ordained A Deacon *

Yes

No

Date of Diaconal Ordination *

Church that ordained you a Deacon * *

Have you been ordained a Presbyter? * *

Yes

No

Date of Presbyterial Ordination *

Church that ordained you a Presbyter *

Have you been consecrated a Bishop *

Yes

No

Date of Episcopal Consecration *

Name of Your Chief Consecrator *

Have you been ordained or commissioned to any other ministries? *

Yes

No

Name of Your Commission or ordination *

Apostle

Prophet

Pastor/Teacher

Evangelist

In the section below, list all places which have served as your ‘home’ church, in chronological order, starting with the most recent.. Please start here with the Church name. *

From *

To *

Ministry Responsibilities

Add Other Churches

Namr of Educational Institution *

From *

To *

Degree(s) Earned *

References Provide two references, one clergy, one lay. Please have each listed reference send a letter of recommendation to the Office of the Patriarch/Diocesan Bishop.

Clergy Reference Name *

Street Address *

Apartment, suite, etc *

City *

State/Province *

Zip Code *

Country *

Phone *

Lay Reference Name *

Add Others

Any Felony Conviction(s) *

Yes

No

Are you aware of any physical or emotional impairment which would affect your ability to minister *

Yes

No

Have you ever been disciplined , dismissed, or suspended from a secular job,ministry, or military service? *

Yes

No

If the answer to either of the above is yes, please explan.

I attest that the information provided in this application is complete and accurate and authorize the United Apostolic & Charismatic Church to confirm this information through the institutions, ministries, and agencies listed above. I understand that I may be asked to provide a release for further information (medical, legal, etc.) if deemed necessary. *

I do so consent

Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, by checking this box, and they were signed by myself with full knowledge and consent and am legally bound to these terms and conditions *

AFFIRMATION OF DOCTRINAL ESSENTIALS * It is by grace through faith in Christ Jesus, by the witness of the Holy Spirit, trusting in the inspiration and supremacy of the Holy Scriptures and with a confirming heart and mind that I affirm the Doctrinal Essentials of the United Apostolic & Charismatic Church. By my signature, as a faithful and accountable ministry leader and/or minister, I will endeavor with God’s help, to live and teach in concord with the spirit and intention of the Doctrinal Essentials that I will be asked to reaffirm annually. *

Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, by checking this box, and they were signed by myself with full knowledge and consent and am legally bound to these terms and conditions

COMMITMENT TO PURITY * Before God, I pledge my commitment to a historical, traditional view of purity, as understood in the Historical Christian Church since the earliest of times. I reject the move of recent times where portions of Christendom have embraced and accepted lifestyles such as homosexuality, promiscuity, fornication, adultery, and incestuous relationships as Biblically acceptable or tolerable. I embrace the heterosexual view of marriage and sexual relationships as God designed and God ordained. I commit myself to purity of life and purity of expression in my sexuality; through fidelity in marriage, and abstinence in singleness. *

Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, by checking this box, and they were signed by myself with full knowledge and consent and am legally bound to these terms and conditions

AFFIRMATION OF AND CONSENT TO CLERGY CODE OF CONDUCT * I hereby acknowledge that I have received and read The United Apostolic & Charismatic Church - Clergy Code of Conduct and that I am fully aware of its terms. I also agree to read and comply with all policies adopted by the UACC. I understand that compliance with this Code is a condition of license, ordination, affirmation, consecration, elevation or induction into any office, Holy Order or Religious Order of the UACC or any of its constituent parts. I understand that if I fail to comply with this Code or other published policies of the United Apostolic & Charismatic Church, my Diocese or applicable laws, it will be addressed and I may be subject to disciplinary action, including a warning, revision of responsibilities, suspension, or dismissal, or removal from clerical status. I understand that the United Apostolic & Charismatic Church and/or its Patriarch from time to time may issue policies which also govern clerical conduct. All of these other policies are incorporated by reference into this Code of Conduct. I confirm that I will comply with all provisions of the Code of Conduct. *

Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, by checking this box, and they were signed by myself with full knowledge and consent and am legally bound to these terms and conditions

CERTIFICATE OF DECLARATION * In the Name of the Father, and of the Son, and of the Holy Spirit. Amen. ~ The One Holy Catholic and Apostolic Church ~ I do solemnly declare that I do believe the Holy Scriptures of the Old and New Testaments to be the Word of God, and to contain all things necessary to salvation. I do believe the teachings and doctrine of the One Holy Catholic Church as they come to us from the Ancient Historical Faith. I do solemnly purpose to conform to the doctrine, discipline, and worship of Christ’s Holy Catholic and Apostolic Church. *

Under penalty of perjury, I herewith affirm that my electronic signature, and all future electronic signatures, by checking this box, and they were signed by myself with full knowledge and consent and am legally bound to these terms and conditions

Demographic Information

Christian Experience / Ordination

Church History

Education

References

Background Information

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