Application for Certified Lay Ministry Status

Application for Certified Lay Ministry Status

A certified lay minister is a professing member of a local congregation who has received special training in Wesleyan doctrine and our denominational polity, and endorsement by the church in order to serve the church as laity. Use this application once you have completed the CLM Foundations Course plus one advanced course to apply to the Heartland Conference for official certified lay ministry status.
Name*

First NameLast Name
Date of Birth*
Birthplace*
Home Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email*
example@example.com
In What Conference Do you Serve?*
Marital Status*
Spouse's Full (Maiden) Name if Married. If not married please type N/A.*
First Name and Last Name (Maiden)

Children's Name(s) and Date(s) of Birth (if you have children)

	Name	DOB
Child 1
Child 2
Child 3
Child 4
Child 5

Are you seeking to have your status in a prior denomination grandfathered in?*
Please briefly describe your prior status and courses you've completed with dates if available.*
Name of Church Membership for 2 years or more (502 2a)*
Name of Clergy recommending you (attach letter from Clergy, including their category) (502 2e)*
Please upload Clergy Letter*

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List one Lay Ministry Course you have taken (502 2b)*
Please upload your transcript or certificate for your Lay Ministry Course.

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List one advanced Lay Ministry Course you have taken (502 3c)*
Please upload your transcript or certificate for the Advanced Lay Ministry Course.

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Area of current service*
Disclosure Statement
I type name* , do hereby certify that I have neither been accused in writing nor convicted of a felony, misdemeanor, or any incident of sexual misconduct or child abuse, except as indicated below.
In the space below provide details of any convictions for felony or misdemeanor or accusations of sexual misconduct and/or child abuse. If there are none, write the word NONE in the space below.*
If you are disclosing any accusations or convictions against you that you dispute or believe should be explained in any way, you have an opportunity at this time to include with this statement any additional information that you believe might be helpful or important regarding the disclosure. Any relevant additional information should be provided on this form. If NONE, please write none in the box. *
Any additional files or supporting documents that you need to upload.

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Statement of Affirmation Doctrine and Social Witness of the Global Methodist Church
I affirm that I have carefully read, studied, and understand Part One, Doctrine, and Part Two, Social Witness of the Transitional Book of Doctrines and Discipline of the Global Methodist Church.*

Yes, I affirmNo, I do not affirm
I affirm I will support, adhere, and maintain the Doctrines and Social Witness of the Transitional Book of Doctrines and Discipline of the Global Methodist Church.*

Yes, I affirmNo, I do not affirm
Authorization for Background Check
I, type name* , understand that the Heartland Annual Conference requires a background check of all persons seeking ordination, appointment, and/or employment. I understand that information which I have provided may be verified by contacting persons and organizations with whom I had contact or who/which may have information concerning me. (502 2d)
I authorize the Heartland Annual Conference to conduct a background check consisting of, without limitation, the following information: county, state, and/or federal criminal records; Department of Motor Vehicle records, records of judgments and/or liens, educational history, employment history, or other information. I also authorize, without reservation, any person, agency, or other entity contacted by or on behalf of the Heartland Annual Conference to furnish the described or similar information.
I waive any and all causes of action that I may have against the Heartland Annual Conference, its members, employees, and agents, and any person, agency, or other entity providing information in connection with the background check for libel, slander, defamation, intentional or negligent infliction of emotional distress or for any other injury of any kind or nature caused by the gathering or supplying of the descried or similar information.
Signature (by signing you attest that all information you provided is accurate and you agree to a background check to be initiated by the Heartland Annual Conference)

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Board of Ministry Contact Information:

Jaimie Willis, Board of Ministry Chair - jwillis@heartlandgmc.org
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Application for Certified Lay Ministry Status

Statement of Affirmation Doctrine and Social Witness of the Global Methodist Church

Board of Ministry Contact Information: