PennDel Ministry Network | Credential Applicant Survey Form

Credential Applicant Survey Form

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

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

Have you or your spouse been divorced?(Required)

Yes

(If yes, please contact Janice at janice@penndel.org for more information)

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

Yes

If yes, please provide church name you attend and include the Lead Pastor's name as well as how you are serving.

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

If you are not attending an Assembly of God church, please explain why you want to receive credentials through the PennDel Ministry Network.

Please include the name of the church you are attending as well as your Pastor's name and contact information.