Memphis Bible Institute Application

Minister's License
Renewal of Minister's License

Elder Candidate
Deacon Candidate
Licensed Minister Candidate

Date / /
mm/dd/yyyy

APPLICANT'S INFORMATION

Full Name: Male Female

Address: Phone

City: State: Zip Code:

Email: Local Church Membership:

Social Security Number: Birthdate mm/dd/yyyy: Birthplace:

Marital Status: Date of Marriage mm/dd/yyyy

Spouse's Name: Birth Date mm/dd/yyyy Birthplace:

Number of Children:	Child's Name:	Birthdate mm/dd/yyyy:
	Child's Name:	Birthdate mm/dd/yyyy:
	Child's Name:	Birthdate mm/dd/yyyy:
	Child's Name:	Birthdate mm/dd/yyyy:

EDUCATION INFORMATION

List schools attended and degrees earned.

School	Name	Year Graduated	Degree	Major/Minor
High School
College / Univ.

Bible College
Seminary
Other

First local minister's license was issued by the local church on mm/dd/yyyy.

What part of a validated Course of Study for Ministers have you completed? 1/4 1/2 3/4 All

RELIGIOUS EXPERIENCE

1. Describe your call into ministry:

2. Describe your conversion:

CHURCH RELATIONS

3. Record of Church Membership (last five years)

Year	Church	Served as

4. Have you ever been involved in church troubles of any kind? Yes No

If yes, please explain:

5. What experience have you had thus far in preaching?

6. Do you sense the urgency of Christians being entirely sanctified? Yes No
Does your ministry result in the sanctification of believers? Yes No
If no to either of the above questions, please explain:

PERSONAL INFORMATION

7. Are you in good health? Yes No If no, state particulars

8 Are your spouse and children in good health? Yes No If no, state particulars

9. Are there physical irregularities in your family that would hinder your ministry? Yes No If yes, please explain

10. Does your spouse support you in your commitment to fulfill your calling? Yes No If no, please explain

11. Have you ever been arrested, convicted or plead "no contest" at any time? Yes No

If yes, please explain:

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