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Application Form
To be completed in Full
PRINT OR TYPE
Name________________________________________________________________
Last First Middle
Date of Birth ___________________________________________________________
Day Month Year
Social Security Number___________________________________________________
Total Number in household, including applicant _____ Total household annual Income__________
Church Membership and Length of Membership_______________________________________
Church Related Activities (with dates) ______________________________________________
____________________________________________________________________________
Communities Activities:
____________________________________________________________________________
Contributions you wish to make to Ministry:
____________________________________________________________________________
Greatest Strengths You Have to Give:
_____________________________________________________________________________
Significant Obstacles to be Overcome:
_____________________________________________________________________________
Two References, excluding family members:
Name___________________________________________________________________
Addres__________________________________________________________________
Telephone Number________________________________________________________
Name___________________________________________________________________
Addres__________________________________________________________________
Telephone Number________________________________________________________
On a separate sheet of paper briefly discuss your interest in ministerial education.
(You may refer to item 6 -11)
Signature________________________________________________________________
Mailing Addresss_________________________________________________________
Phone Number ___________________________________________________________
ALL APPLICATIONS MUST BE
SUBMITTED BY MARCH 28, 2008
TO
MINISTER ROSEMARY SIMMONS-BROWN
341 COBURN TOWN ROAD
RIDGEVILLE, SOUTH CAROLINA 29472