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____________________ _______________ _______________ _____________________
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)
___________________________________________________
_____________________________________________________________________________
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? _______________________________
Briefly describe your last five
years of work experience_________________________________
______________________________________________________________________________
______________________________________________________________________________
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?