PennDel Ministry Network | Credential Applicant Survey Form

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Credential Pre-Application Inquiry Form

This information provided in this form will be evaluated to determine your qualification to apply for AG Credentials.

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Applicant's Full Legal Name(Required)

First Last

Spouse's Full Legal Name(Required)

First Last

Applicant's Email(Required)

Spouse's Email(Required)

What is your marital status?(Required)

Single

Married

Have you (or your spouse) ever been divorced?(Required)

Yes

No

Not applicable

Have you ever filed for bankruptcy?(Required)

Yes

No

Applicant's Phone(Required)

Applicant's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Applicant's Date of Salvation(Required)

(month and year, mm/yyyy)

Applicant's Date of Water Baptism(Required)

(month and year, mm/yyyy)

Have you been baptized in the Holy Spirit? (with evidence of speaking in tongues)(Required)

Yes

No

Applicant's Date of Holy Spirit Baptism(Required)

(If yes, enter month and year, mm/yyyy;)

Do you attend an Assembly of God church?(Required)

Yes

No

If not, please share your reasons for seeking credentials through the PennDel Ministry Network.(Required)

Please include the Lead Pastor’s contact information.

Lead Pastor's Name(Required)

First Last

Church's Name(Required)

Please state if you are a full-time or part-time staff member. If not, describe your volunteer role.(Required)

Please explain why you want to apply for credentials and why the ministry you are involved in would require credentials.(Required)

Have you taken Bible/Theology courses?(Required)

Note: Educational requirements must be completed before applying for credentials.

Yes

No

If Yes. Where? What school/program?(Required)

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Originally the Pennsylvania-Delaware District Council of the Assemblies of God.

Two states. One mission. The Network exists to resource the local church. Equipping, empowering, and fostering healthy pastors and thriving churches.

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