CHICAGO METROPOLITAN BAPTIST ASSOCIATION

2237 W. 120th STREET

BLUE ISLAND, IL  60406

 

ASSESSMENT CENTER APPLICATION

____________________    _______________     _______________     _____________________

Name (Last)                                 First                          Middle                        Preferred Name

_____  ___________________                _____________________________________________

Sex          Birth date (M/D/Y)                             Birthplace

 

U.S. Citizen  yes____   no___ if Naturalized, when & where _____________________________

 

Immigration Status & Number___________________ Date of entry into USA_______________

 

_______________________   _________________  ____     ________     __________________

Address (residence)                     City                            State       Zip code         Phone

 

Marital Status (Circle one)     single    engaged    married    divorced     remarried

 

Date of marriage (current) ____________  (first)_____________  Date of divorce___________

 

Children (Names, Ages & Sex) ___________________________________________________

_____________________________________________________________________________

Religious Experience

Age and Place of Conversion______________________________________________________

Age and Place of Baptism ________________________________________________________

Place you first united with a Southern Baptist Church___________________________________

What Southern Baptist Church are you now a member of? _______________________________

Work Experience

Briefly describe your last five years of work experience_________________________________

______________________________________________________________________________

______________________________________________________________________________

Education and Training

High School:  ____________________________________ From__________ to____________

College: _________________________________________  From _________ to ___________

Seminary: ________________________________________ From _________ to ___________

Language used conversationally ___________________________________________________

Is there anything in your lifestyle that could be of embarrassment to your ministry?

Yes____   No____  If yes, please explain.


Pre-Assessment Questions

 

 

Please respond to the following questions as accurately as possible while maintaining brevity, one paragraph unless noted otherwise.  This section is for primary worker only.  Spouse need not complete.

 

1.       In a half-page or less, describe your calling to the ministry of church planting.

 

2.       In what ways has God gifted you to serve in a Church Planting ministry?  Please include how these gifts were identified (i.e. spiritual gift inventory, affirmation of church body, etc.) and a description of your operating in the gifts.

 

3.       How are you involved in personal evangelism?  Describe your most recent effort to lead someone to a personal conversion experience, giving time, place and result.

 

4.       Describe an experience in which you gathered people together to accomplish a task.  Include your responsibilities and the results.

 

5.       Do you agree with Southern Baptists’ statement of generally held convictions called The Baptist Faith and Message?

 

6.       What pastor models have you admired and how do you see yourself as similar to or different from them?

 

7.       Where have you felt you have exercised strong leadership in the past?  Explain.

 

8.       Do you have the physical and emotional stamina to take on this kind of tough role in the church, and how will it enhance your abilities as a church planter?

 

9.       Why have so many “unchurched” not responded to the invitation to worship at our existing churches and what would you do differently to reach them?