Pastor Information Form

Page 1 of 5 pages
Date:
PASTOR INFORMATION FORM

Please fill in the following information
GENERAL INFORMATION:
Name:
Address:
City: State: Zip:
Home Phone: ( ) Office Phone: ( )

E-mail:
Date of Birth: Place of Birth: Citizenship:
Marital Status: ! Single ! Married ! Divorced ! Remarried ! Widowed

Spouse’s Name: Date of Birth: Date of Marriage:
Spouse’s specialized training:
Do you expect your spouse to work outside the home? ! Yes ! No
Children: Names Ages Gender
Other Dependents:
Health considerations for you or your family you wish the congregation to be aware of:
8941 33rd St North, Lake Elmo, MN 55042 | 651-739-1474 | homeoffice@ccccusa.com | www.ccccusa.com

Conservative Congregational Christian Conference
Pastor Information Form— (cont.) Page 2 of 5 pages

Pastor Information Form— (cont.)
EDUCATION:
College:
Degree: Date of Graduation:
Major: Minor:
Seminary:
Degree: Date of Graduation:
Major: Minor:
Other Graduate Study:

Continuing Education: (workshops, seminars, etc.)
Specialized Training:
PROFESSIONAL INFORMATION:
Present Position:
! Senior Pastor ! Associate Pastor ! Assistant Pastor
! Youth Pastor ! Director of Christian Education
! Other: (please specify)
Church or Institution of Present Position:
Name:
Address:
City: State: Zip:
Phone: ( ) Website:
E-mail:
8941 33rd St North, Lake Elmo, MN 55042 | 651-739-1474 | homeoffice@ccccusa.com | www.ccccusa.com Revised 11-201
Page 3 of 5 pages
PROFESSIONAL INFORMATION: (cont)

Of what church(es) are you a member?
Date of Ordination: Church or denomination ordained by?
Date of License: (if not ordained) Church or denomination licensed by?
Where is your present ministerial standing?
Have you attended a CCCC Annual Gathering? ! Yes ! No
MINISTRY EXPERIENCE: List the last four positions only.

Please include: position/title; church name, address, phone; size; dates of tenure; full/part-time;
reason for leaving
1.
2.
3.
4.
In present/most recent ministry position what is the church’s:
a. Membership: b. Sunday School attendance:
c. Average attendance: d. Total budget:
Page 4 of 5 pages
TOTAL YEARS OF PASTORAL MINISTRY: (Enter number of years)

Senior pastor Minister of Visitation Minister of Counseling
Solo pastor Minister of Evangelism Youth minister
Assistant pastor Minister of Music/Worship Military chaplain
Minister of Christian Ed Minister of Missions Institutional chaplain
Parachurch ministry Other: (please specify)
TOTAL YEARS of Pastoral Experience
Other work experience contributing to effective ministry:
What activities are you involved in beyond the local church?
THEOLOGICAL INFORMATION:
The churches of the Conservative Congregational Christian Conference represent a cross section of the Evangelical
community. This section helps make honest matches theologically with the pastor and the church.
1. Check the Evangelical sub-group that describes you: (Check all that apply)
! Fundamentalist ! Dispensational ! Conservative Evangelical
! Reformed ! Wesleyan ! Progressive Evangelical
! Charismatic ! Pentecostal ! Main-line Evangelical
2. Check your Baptismal practices:
! Believer’s Baptism ! Immersion ! Infant Baptism ! Sprinkle/Pour
3. Check your view of the Charismatic/Pentecostal movement:
! Opposed ! Neutral ! Agree with ! Endorse
4. Check your view of women serving as Church Elders or Pastors:
! Approve ! Oppose
5. Which word(s) best describe your style of worship:
! Liturgical ! Traditional ! Contemporary ! Blended
6. Which translation of the Bible do you use most often:
Page 5 of 5 pages
COMMUNITY PREFERENCES: (Mark an “X” for your preferences. Mark an “N” for options you would NOT consider.)
Geographic locale:
New England (ME, VT, NH, MA, CT, RI) Northeast (NY, NJ, PA)
East Central (MD, DE, VA, WV) Southeast (NC, SC, GA, FL)
North Central (MI, WI, IA, MN, ND, SD) Midwest (OH, IL, IN, KY, MO, KS, NE)
South Central (TN, AL, MS, LA) Northwest (MT, WY, ID, WA, OR, AK)
West (CO, NM, AZ, UT, NZ, CA, HI) Southwest (OK, TX, AR)
Community:
Rural Suburban Urban (downtown)
Small town Urban (residential) Inner city
Size of church:
under 100 101-250 251-500
501-1000 over 1000 members no preference
Type of pastoral position:
Senior pastor Solo pastor Associate pastor Church plant
PASTORAL ACTIVITIES:
On a scale of 1 to 10, evaluate the characteristics in a pastor that you are seeking. Mark a 10 for the
areas of greatest strength and write 1 for the area of least ability.
Preaching Teaching Evangelism Discipleship
Worship leading Administration Counseling Missions
Lay ministry Small groups Christian Ed Visitation
Youth work College & Career Seniors Singles
Families Children Church Growth Leadership
Development
References: (Please list five references )

1.
2.
3.
4.
5.
The Conservative Congregational Christian Conference provides to churches information about search processes and maintains a list of clergy seeking
calls. The Conference also provides information to clergy about church vacancies. The Conference makes no representation as to the fitness of any clergy
person or the accuracy of information provided by a congregation. Each clergy person is responsible for evaluating each congregation's appropriateness to
his calling. Each congregation is responsible for its’ own hiring process and decision. All terms and conditions of employment are the sole responsibility of
the local church.
NOTE: Please treat this Pastor Information Form in a confidential manner. We hope you will assist us in avoiding embarrassment to the pastor who submitted this form. The
CCCC expects all recipients of the information on this form to preserve its contents with the strictest of confidentiality.

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Page 1 of 5 pages

PASTOR INFORMATION FORM

City: State: Zip:

Home Phone: ( ) Office Phone: ( )

Date of Birth: Place of Birth: Citizenship:

Marital Status: ! Single ! Married ! Divorced ! Remarried ! Widowed

8941 33rd St North, Lake Elmo, MN 55042 | 651-739-1474 | homeoffice@ccccusa.com | www.ccccusa.com

Pastor Information Form— (cont.) Page 2 of 5 pages

Degree: Date of Graduation:

Degree: Date of Graduation:

Other Graduate Study:

City: State: Zip:

PROFESSIONAL INFORMATION: (cont)

Date of Ordination: Church or denomination ordained by?

Date of License: (if not ordained) Church or denomination licensed by?

Where is your present ministerial standing?

Have you attended a CCCC Annual Gathering? ! Yes ! No

MINISTRY EXPERIENCE: List the last four positions only.

In present/most recent ministry position what is the church’s:

a. Membership: b. Sunday School attendance:

c. Average attendance: d. Total budget:

Pastor Information Form— (cont.)

TOTAL YEARS OF PASTORAL MINISTRY: (Enter number of years)

What activities are you involved in beyond the local church?

References: (Please list five references )

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