North American Missions Application Page 1 of 4

North American Missions Application Page 1 of 4

West Virginia District UPCI • North American Missions Dept.

Director: Eugene Whetzel (304) 703-2202 • Secretary: Robert Fazzalore (304) 813-1708

North American Missions ApplicationPage 1 of 4

Date of Application: ______

I desire to start and establish a new church in the area/city of:______

Contact / Family Info:

1. Name:______Age: ______Date of Birth: ______

2. Mailing Address:______City: ______State: ____ Zip: ______

3. Best phones to reach me: ______

4. Email Address: ______

5. Spouse’s Name:______Age: ______Date of Birth: ______

6. Children’s Names & Ages: ______

______

Ministerial Status / History:

7. Present District: ______

8. Superintendent:______Ph: ______Email: ______

9. Presbyter:______Ph: ______Email: ______

10. Pastor:______Ph: ______Email: ______

11. Present Field of Labor (or previous, if moved): ______

Where:______For How Long? ______

12. Other districts in which you have pastored or held license: ______

13. How long have you been in the ministry? ______Local ______General ______Ordained ______

14. Preceding Pastorates: ______

15. Explain your convictions concerning ministerial ethics: ______

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______

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Calling / Proposed Work:

16. Why are you interested in this city? ______

______

17. When would you be able to move to this city? ______

18. What are the names and locations of the two United Pentecostal Churches nearest to the location of the proposed N.A. Mission Church?

A. Church Name: ______Distance from Proposed Church: ______miles ______minutes

Church Pastor:______City: ______State: ______

B. Church Name: ______Distance from Proposed Church: ______miles ______minutes

Church Pastor:______City: ______State: ______

19. Do you know any Apostolic people in the target city? Yes ____No _____

20. Have you made any contacts with these people? Yes ____ No _____

21. Are any of these people members of a United Pentecostal Church? Yes ____ No _____

22. Are any of these people members of another Apostolic Church? Yes ____ No _____

23. Would you accept members of another Apostolic Church into your new work as members without working with the pastor? Yes ____ No _____

24. Is there any (non-UPCI) Apostolic Church located within the target city?Yes ____ No _____

25. How does your family feel about this new work? ______

______

______

Personal Info / More History:

26. What is your state of health? Good ______Fair ______Poor ______

Details (if needed):______

27. What is your spouse’s state of health? Good ______Fair ______Poor ______

Details (if needed):______

28. How many souls have you won outside the pulpit during the past two years? ______

29. How many Home Bible Studies have you and your spouse taught in the past two years? ______

30. How long do you think that a pastor should stay with a new work before moving to another?______

31. How long do you plan to stay in this city?______

32. Will you cooperate with the District to the best of your ability?Yes ____ No _____

33. Will you give to North American Missions and to Global Missions?Yes ____ No _____

34. What kind of work do you do?______

______

35. How are you going to support your family?______

______

36. Do you have any outstanding bills? Yes ____ No _____ Are your payments current? Yes ____ No _____

38. Approximately how much do you owe? Mortgage_____ Auto_____ Charge Cards_____ Bank Notes_____ Store Accounts_____ Other_____

______

39. Are you and your spouse good money managers? Me: Yes ____ No _____My Spouse: Yes ____ No _____

40. Do you hereby authorize the District to run a Credit Reference Check on your name?Yes ____ No _____

41. My Social Security Number:______My Spouse’s Social Security #: ______

42. What do you preach to be essentials as the Bible requirements for salvation? ______

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______

______

43. What is your approach in presenting holiness to new converts? ______

______

______

44. Do you have a television set in your home?Yes ____ No _____

For the purposes of this application, “television set” is defined as “The appliance sold universally as a television that is connected to a device that enables the reception of programming, such as cable, satellite, or an antenna.”

44. If called upon to do so would you fill a District office?Yes ____ No _____

45. Is your Pastor supporting your move? Yes ____ No _____ Will he give you a letter of recommendation? Yes ____ No _____

Please have your Pastor send a letter of recommendation to the District Superintendent and the District NAM Director.

45. Will your District Superintendent give you a letter of recommendation?Yes ____ No _____

Please have your District Superintendent send a letter of recommendation to the District Superintendent and the District NAM Director.

46. Are you applying for N.A. Missionary status, or simply for permission to start a new church, or both? ______

I have answered the above questions to the best of my knowledge and understanding. If I am approved as a North American Missionary, I pledge to cooperate with the WV Department of North American Missions in every way possible, as well as with the WV District.

Date: ______Signature of Applicant: ______

Notes to the Applicant:

Please attach a photo of you and your family when submitting this application,

Also, please include a personal note or letter covering anything you feel is important to express your burden more fully.

References:

Please give the names, contact info, and complete mailing addresses with zip codes, of not less than four persons who are qualified to give further information about you:

1. Name: ______Phone(s): ______Email: ______

Mailing Address:______City: ______State: ____ Zip: ______

2. Name: ______Phone(s): ______Email: ______

Mailing Address:______City: ______State: ____ Zip: ______

3. Name: ______Phone(s): ______Email: ______

Mailing Address:______City: ______State: ____ Zip: ______

4. Name: ______Phone(s): ______Email: ______

Mailing Address:______City: ______State: ____ Zip: ______

Return completed application with any other pertinent info to: NAM-WV Missions, 115 W. Brighton Ave. Moorefield, WV. 26836

Note: The following is for board use only:

The foregoing application has been reviewed by the WV Dept. of North American Missions on ______(date)

….and [ ] does [ ] does not have its recommendation for the following reasons:

______

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Signature of WV NAM Director: ______

The foregoing application wasreviewed by the West Virginia District Board on ______(date)

….and was [ ] approved [ ] disapproved

….If approved, we recommend that the applicant be granted [ ] full [ ] partial benefits as a North American Missionary in the District of West Virginia (please explain):

District Superintendent______

______

District Secretary______

______

Presbyter ______

______

Presbyter ______

______

Presbyter ______

______

Presbyter ______

______

Presbyter ______

______

Presbyter ______

______

After application has been approved, please return to the District Director of North American Missions to be placed in the applicant’s file.