Personal information:

Name_____________________________________________________________________

Address____________________________________________________________________

City ____________________________________ State ___________________________ Zip _____________

Date of Birth ____________________________________ E-mail _____________________________________

Phone (home) __________________________________ Phone (work) ________________________________

Church Membership:

Congration Name __________________________________________________________________________

City __________________________________________ State _________________

Area MInistry:

___	1	Northwestern Kansas
___	2	Central & Southwestern Kansas
___	3	North Central Kansas (incl. Salina & Lindsborg)
___	4	North Central Kansas (incl. Manhattan)
___	5	South Central Kansas (incl. Wichita & Hutchinson)
___	6	Northeastern Kansas/Northwestern Missouri
___	7	Kansas City Metro Area
___	8	Southeastern Kansas & South Central Missouri
___	9	Central & Northeastern Missouri
___	10	St. Louis Metro Area & Southeastern Missouri

Recent participation in your congregation's activities, ministries....especially as pertaining to your skills and abilities:

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Family:

___

Married

___

Divorced

___

Widowed

___

Single

Spouse's Name ______________________________________________________

Children's Names and Ages ______________________________________________________________________________________________

Education:

High School ___________________________________________ Graduation Date _______________________

College(s)	Majored In	Degree Earned	Degree Date

Employment History:

Organization	Begin/End Dates	Position

(If needed on this...continue on another sheet of paper.)

ON A SEPARATE SHEET OF PAPER COMPLETE THESE QUESTIONS:

1. Why are you interested in the Parish MInistry Associate Program?

2. Write a Spiritual Autobiography -- share your faith journey (maximum 500 words).

 

Affirmation:

I affirm that the information in this application is correct. I also authorize the Central States Synod to request and utilize personal information on me acquired through a background check including but not limited to police and court records and credit records. Applicant's Signature _____________________________________________ Date ______________

Endorsement by Pastor of Applicant's Congregation:

I support and endorse this application for PMA Student Status. Pastor's Endorsement Signature ________________________________Date __________

 

Send completed form to:

Parish Ministry Associate Program

Central States Synod - ELCA

3210 Michigan Ave

Kansas City, MO 64109-2055

NO APPLICATION FEE REQUIRED FOR PMA DISCOVERY PHASE

For office use only:
Action:	___	Approve
	___	Deny

Comments:

 

 

Bishop's/ Bishop's Designee Signature ________________________________________________ Date _________________