Membership Application Membership Application Fields marked with an * are required Initials * Level of Credentials (applied for) * Associate Minister Licensed Minister Ordained Minister First Name * Last Name * Address * City * US States * - Select State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST ARMED FORCES AMERICA (EXCEPT CANADA) ARMED FORCES PACIFIC Mailing Address(if different) Home Phone * Work Phone * Mobile Phone * Select * Married Single Divorced Widow(er) Remarried Seperated Spouse's Name * If divorce has been marked, please provide a brief explanation below: (Attach additional notes if necessary) * EDUCATIONAL HISTORY * Beginning with after school, list all educational institutions attended.Name of School Dates Attended Major Diploma or Degree Earned SECULAR OCCUPATIONAL EXPERIENCE * Please list all secular work experience starting with most recent employer and going back 10 years.Name of Employer Duties Performed or Title Dates MINISTRY EXPERIENCE (Current-Check all the apply) * Pastor Assoc. Pastor Youth Pastor Min. Of Music Evangelist Missionary Teacher Ministry Of Children Church Board Member Other Please give three ministerial references and their contact information. * Church/Organization Contact Person Contact Phone Number Email Years Known Please list all ministry experience starting with most recent service * Place of Service Position/Duties Performed/Title Dates Do you currently hold ministerial credentials? If Yes, with Whom? * Have you ever been denied credentials with any other organization? If yes, explain. * Please initial----Yes , I have reviewed and accepted the doctrinal statement of UTDMI. * Please Initial----Yes , I understand there is an annual fee for credential recognition with UTDMI. * DOCTRINAL POSITION * Please give a brief statement on your position for each area listed:The BibleThe TrinityWater BaptismThe Baptism of the Holy Ghost Email * Confirm First Name (By Confirming, you are Digital Signing) * Confirm Last Name (By Confirming, you are Digital Signing) * HTML The $50.00 annual membership fee must accompany this application before it will be processed. Make checks payable to “UCSS.” For licensed and ordained applicants a letter of recommendation from the individual’s pastor, ministerial, or educational peer must accompany this application. If you are a human seeing this field, please leave it empty.
