Upper Laurel Baptist Church, Inc.

9940 Hwy 23, Mars Hill, NC 28754

Pastoral Application Form

Personal Information

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Years at this address

Date of Birth

Date

Telephone Home/Cell/Work

Email

example@example.com

Authorized to work in the US?

Years lived in US

Marital Status:

If married, Spouse's name

Is Spouse a Christian?

Children names and ages

Ministry & Spiritual Background

Are you licensed?

If Yes, date of licensure

Date

If yes, place of licensure

Are you ordained?

If yes, date of ordination

Date

If yes, place of ordination

Denomination/Affiliation

Have you been baptized by immersion?

If not, would you consider baptism by immersion?

Years of ministry experience (4-7 preferred)

Have you ever filed for bankruptcy?

If yes explain

Criminal / Misconduct Questions

Have you ever been convicted of a felony or misdemenor?

Have you ever been investigated for misconduct by an employer or organization?

Have you ever been disciplined, suspended, terminated or asked to leave for sexual misconduct or harassment?

Have you ever been charged with a crime involving minors?

Have you ever plead guilty to any crime (other than minor traffic)?

Have you ever been suspended, discharged or resigned in lieu of discharge?

Have you ever been dismissed from employment by a congregation?

Have you ever resigned from a church position amid charges of misconduct?

Have you ever been the subject of a restraining/protective order?

Are you currently under investigation for misconduct?

If yes to any of the above please explain. Ensure that each explanation includes relevant dates, descriptions of the incident or situation and any actions taken or resolutions reached. Attach additional pages as necessary. All information provided will be treated as confidential and used solely for assessment purposes.

Work & Ministry Experience (Past 5 Years)

Responsibilities & Achievements

Leadership & Ministry - Describe your strongest leadership and ministry areas: (if additional explanation is needed, please upload file below)

Describe your strongest leadership and ministry areas

Describe areas of weakness and how you are growing in them

Personal testimony & call to Ministry (if additional explanation is needed, please upload file below)

Please share your salvation experience, call to ministry, and spiritual journey.

Spiritual References (Do Not List Family) (Provide Three)

	Name	Email	Phone	Relationship
1
2
3

Professional References (Provide Three)

	Name	Email	Phone	Relationship
1
2
3

Social Media Accounts/Links to Preaching Videos (List URLs or handles)

Agreement (Please Read Carefully)

Please Initial: I certify all information is accurate and complete to the best of my knowledge

Please Initial: I understand that false statements may result in termination or refusal of hire

Please Initial: I understand employment is at will and may be ended by either party at any time

Please Initial: I give permission for background and reference checks by Upper Laurel Baptist Church Incorporated

Printed Name

Signature

Date

File Upload