CPM Form 5A: Application to be Enrolled by Presbytery as a Candidate

CPM Form 5A: Application to be Enrolled by Presbytery as a Candidate

PC(USA) Form; Revised December 2011
Date *

Month Day Year
Name of applicant *

First Name Middle Name Last Name
Current Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Main phone *

Area Code Phone Number
Phone type *
Alternate phone

Area Code Phone Number
Phone type *
Permanent address (if same, write same)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Church of membership *
Church address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Date enrolled as an inquirer *

Month Day Year
In what church occupation are you interested in at this time? *
(e.g. pastor, youth minister, mission worker, educator)
Present or most recent school attended *
Location *
Date of graduation *

Month Day Year
Inquirer's Statement
I hereby apply to be enrolled by __________ Presbytery as a candidate.
(name of presbytery)
Type a question

I certify no civil, criminal, ecclesiastical complaint has ever been sustained or is pending against me. I am unable to make the above certification. I offer instead on the attachment a description of the complaint and/or outcome of the situation with explanatory comments.
Upload description of the complaint and/or outcome of the situation with explanatory comments here.

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I certify that the information in this application is true and correct. If recommended to be a candidate for the ministry of Word and Sacrament, I promising reliance upon the grace of God to participate diligently and wholeheartedly with the session and presbytery's committee/commission in matters which concern my preparation. *
References for Outcomes of Inquiry
Name *

Title First Name Middle Initial Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Preferred phone number *

Area Code Phone Number
Phone type *
Email
example@example.com
In what capacity have you worked with this person? *
Name *

Prefix First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Preferred phone number *

Area Code Phone Number
Phone type *
Email
example@example.com
In what capacity have you worked with this person? *
Name *

Title First Name Middle Initial Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Preferred phone number *

Area Code Phone Number
Phone type *
Email
example@example.com
In what capacity have you worked with this person? *
Please also submit your required responses to the Candidacy Questions and your personal Statment of Faith.
Should be Empty:

CPM Form 5A: Application to be Enrolled by Presbytery as a Candidate

Inquirer's Statement

References for Outcomes of Inquiry