Certified Lay Minister Application Data on ApplicantName(Required) Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Middle Last Suffix Preferred First Name(Required)By what name do you prefer to be addressed? (Example: Cathy instead of Catherine; Bob instead of Robert.) Default is legal first name. Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Primary Phone(Required)Secondary PhoneEmail(Required) Enter Email Confirm Email Birth Date(Required) Month Day Year Gender(Required) Race/Ethnicity(Required) Data on Applicant's ChurchPlease enter the following data about your home church. Part of your application includes signatures from your pastor, church council chair, s/pprc chair, and district superintendent. Certified lay ministry is a team ministry and these individuals are a part of your team! Please be sure you are in communication with all four. When you submit this application, we will send automated emails to each using the email addresses you provide. They will then be prompted to fill out a very brief form acknowledging their support of you entering this program. That form counts as their “electronic signature.”Church Name(Required) District(Required)This form is only for those interested in becoming certified lay ministers in the North Carolina Conference. In which North Carolina district is your church located?(Please select district)BeaconCapitalCorridorFairwayGatewayHarborHeritageSoundPastor's Name(Required) First Last Pastor's Email(Required) Enter Email Confirm Email Church Council Chair's Name(Required) First Last Church Council Chair's Email(Required) Enter Email Confirm Email Staff / Pastor-Parish Relations Committee Chair's Name(Required) First Last Staff / Pastor-Parish Relations Committiee Chair's Email(Required) Enter Email Confirm Email District Superintendent's Name(Required) First Last District Superintendent's Email(Required) Enter Email Confirm Email Education and LeadershipEducation(Required)Please very briefly describe your educational background, including the highest form of education you have received. If you have participated in any formal theological training (Course of Study, seminary, etc.), please describe.Local Church Leadership(Required)Briefly describe your involvement in your local church, such as leadership positions, groups you enjoy, church activities, etc.District/Conference LeadershipIf you have served in any leadership capacity at the district or conference level (committees, delegate, etc.), please describe.Community LeadershipDescribe your community involvement and volunteer work, such as participation in community organizations, social clubs, service agencies, or any community outreach programs.CallingInterest(Required)What draws you to certified lay ministry? What do you hope to gain through participation in this program? Timing(Required)Knowing that the time commitment for the candidate training program and your work as a certified lay minister is significant, what convinces you that now is the right time to pursue certification as a lay minister?Call(Required)Knowing that continued discernment during the candidate training program may shift your goals, what can you share now about your understanding of your call? For example, do you envision your work as a CLM to take place in your home church? If so, in what capacity? Alternatively, if you are considering an assignment as a lay pastor of another congregation, please share that. Next StepsPrerequisites Needed(Required)The following courses are considered pre-requisites for the CLM candidate training program. Please select all of the following that you still need to complete. Basic Course in Lay Servant Ministries Living our United Methodist Beliefs (UM History) Life Together in the UMC (UM Polity) Safe Sanctuaries (special course for CLMs) Optics (conference anti-bias training) IDI (Intercultural Development Inventory) Questions / FeedbackDo you have any questions or concerns that you would like to share with us at this juncture?