In-Care and Standing Recognition Application Form

General Contact Information

Phone

Reason for Application
For Those Seeking Ordination or Commissioning
For Those Seeking Recognition of Standing
Please List Post-High School Education
Please List Last Three Employers/Positions (beginning with most recent)
Employer 3
Employer 2
Employer 1
Disclosure Statement
(Check all that apply.)
Release for Criminal Background Check

By typing your name in the space below: "I certify that the above is true and accurate and that in my judgment there are no other facts or circumstances involving me or my background related to my being entrusted with the responsibilities of ministry in the Christian Church (Disciples of Christ). Further, I agree that the Northwest Region is authorized to conduct a Washington State Background Check at the beginning of this process, and that a more complete background check will be performed, at my expense, before final approval for ordination, commissioning, or standing is given." (Current cost of later background check is $160.)