Application for Care

Name

First Name

Last Name

Middle Initial

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email Address

Date of Birth

Place of Birth

Marital Status

Please check all that apply

Single

Engaged

Married

Widowed

Separated

Divorced

Wife's Name & Date of Marriage (if applicable)

Children's Names and Ages (if applicable)

Church of which you are a member

Educational experience since high school

Do you plan on pursuing further education beyond your present degree program?

Yes

1a. Give a brief account of how you became a Christian and your subsequent pilgrimage and spiritual development.

1b. Describe briefly your personal and if married, family practice in church attendance, prayer and Bible study.

2a. Why do you desire to come under care with a view to ordination in the gospel ministry?

2b. In what ways have you served the church and what encouragement have you received?

3. Why and how do you desire to serve in the Orthodox Presbyterian Church?