Interested in Church Planting

For anyone interested in being a Dakota Baptist Convention Church Planter or a Church Planting Team Member

Date*
Date Format: MM slash DD slash YYYY
Personal Background
Full Name*
As on your Social Security Card
First Middle Last
Home Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone*
Email Address*
Birthday*
Date Format: MM slash DD slash YYYY
Currently Employed By*
Job Title*
Marital Status:*
- Single
- Married
- Divorced
- Widowed
Name of Spouse*
First Last
Are you a U.S. Citizen?*
- Yes
- No
If not born in the U.S., please indicate your country of origin.*
If naturalized, please provide the following:*
Date Location
If not a U.S. citizen, what is your immigration status?*
What type of VISA do you have?*
What was your date of entry in the U.S.?*
Date Format: MM slash DD slash YYYY
What languages do you use conversationally?*
Do you have a desire to plant a church in a particular city or geographical area in South Dakota or North Dakota, and / or with a particular focus or language group?*
Rather than being the lead church planter, do you desire to be a church planting team member? (If so, please also share your skills you would bring to the church planting team.)*
Are you in agreement with the Baptist Faith and Message 2000 in its entirety?*
- Yes
- No
Please share your call to church planting and any church planting experience you have had.*
I would like to receive a copy of this report.
- Send me confirmation.

Spiritual Background
Age and place of your conversion:*
Age Place
Have you experience believer's baptism since the time of your conversion?*
- Yes
- No
Age at which you were baptized?*
Name, location, and affiliation of the church in which you were baptized:*
Year in which you first affiliated with a Southern Baptist Church:*
Name, location, and affiliation of the church of which you are now a member?*
Length of time you have been a member of your current church?*
Have you been ordained by a local church to the Gospel Ministry?*
- Yes
- No
If yes, to the above, please provide the name, location, and affiliation of the church in which you were ordained:*
Year in which you were ordained?*
Have you ever attended a bible college or seminary?*
- Yes
- No
If yes, please provide the name of the school and years attended, any diploma or degree earned:*

Personal Background