Credential Application - Notification Form - VIC/TAS • CRC Churches International

Credential Application - Notification Form - VIC/TAS

This is NOT a Credential Application.

Please note that it is important that all questions are answered. Although some questions may seem to be intrusive, this is necessary as a part of our Duty of Care and Ministerial Ethics. The information provided will only be used to help the decision-making bodies as a part of the interview process. Note also that one copy of this application will be kept in a secure location after the completion of the interview process, and all additional copies will be destroyed or deleted.

In making this application, you are agreeing to your name being circulated to the members of the CRC VIC/TAS State Council.

Full Name:

Coaching Pastor:

Section 1: Personal

1. First Name *

Last Name *

2. Preferred Name *

3. Do you have any other names/alias? *

If yes, please provide details *

4. Home Address *

5. Mailing Address (if different from above)

6. Phone Number

6a. Mobile Number *

7. Email Address *

8. Date of Birth *

Place of Birth *

9. Gender *

10. Citizenship status *

Australian

Permanent Resident with valid visa

Other

If you selected other, please provide details

11. Marital Status *

If separated or divorced, please provide details

Q12 and 13 are for married, re-married and engaged candidates only

12. How long have you been married? *

13. How many times have you married? *

Please follow the link and read the CRC's Statement on Divorce and Re-marriage Declaration.

Click Here

I declare that I have read and understood the CRC's Statement on Divorce and Remarriage and I am willing to abide by the document *

I have read and understood this Statement

14. Name of spouse/fiancé: *

14a. Has your spouse ever been divorced? *

If yes, please provide details (please include how many marriages) *

b. Have you and your spouse ever had a significant period of separation that could have led to divorce? *

If yes, please provide details *

c. Since your marriage, have you or your spouse ever been in an inappropriate relationship that involved physical and/or emotional intimacy? *

If yes, please provide details *

15. Does your spouse/fiance support this application? *

If no, please provide details *

Section 2: Credential

Please indicate which credential the candidate is applying for: *

Indicate speciality *

16. Have you previously held a credential with any other denomination? *

If yes, please provide details *

17. Have you ever been refused a credential with CRC Churches International or any other denomination, or had a credential revoked? *

If yes, please provide details *

18. Are you (and if married, your spouse) a member of an organisation which may be in conflict with CRC Churches International beliefs, vision and values? *

If yes, please provide details *

19. Briefly outline your reason for seeking a credential with CRC Churches International. *

Section 3: Church

20. Are you a member or a regular attendee of a CRC Churches International church? *

a. Name and locality of your local church *

b. Name of Senior Minister *

c. Senior Minister Contact Number *

d. How long have you been in this church? *

Section 4: Character

23. Are there any issues in your physical or relational home environment that is likely to hinder your effectiveness in ministry? *

If yes, please provide details *

24. Check any statement which applies to you, and if married or engaged, your spouse/fiance

24a. Currently have:

A drug dependency or addiction (e.g. tobacco, alcohol, prescribed medication, illegal substances)

A gambling addiction

A pornography addiction

A problem or implication in an issue relating to child abuse

Significant experiences of same-sex attraction

A diagnosed mental illness for which I take medication or have regular treatment

A criminal record

Please provide details for any indicated areas above *

24b. Previously had:

Used or distributed illegal substances

Been involved in community disturbances and/or domestic violence

Undergone therapy and/or taken medication for a mental illness

Been involved in criminal activity

Please provide details for any indicated areas above *

25. Have you ever experienced any sexual attraction towards children. *

If yes, please provide details *

26. Have you ever experienced any sexual attraction towards someone of the same sex? *

If yes, please provide details

Rate yourself in the following areas:

Maturity (personal development, ability to cope) *

Motivation (self-discipline, sense of purpose, passion, depth od commitment) *

Reliability (dependable, diligent, responsible) *

Emotional Stability (poise, self-control, reaction to situations) *

Judgement (problem analysis and solving) *

Oral Expression (clarity of speech and thought, coherence) *

Interpersonal relationships (rapport, courteous, pleasant, understanding) *

Empathy (sensitive to the needs of others) *

Work Habits (stamina, conscientious, persevering, resourceful, takes initiative) *

Leadership (creative, confident, charismatic, decisive) *

Personal appearance (well groomed, modest dress) *

Integrity (truthful, moral character, keeps ones word and confidences, avoids gossip) *

Sexual Purity (disciplined mind, disciplined passions, disciplined eyes) *

Academic ability (studious, committed to lifelong learning) *

Reaction to criticism (able to cope with negative or hurtful situations) *

Preaching-teaching ministry (shares spiritual truths on a regular basis) *

Cooperation (teachable, works under supervision and in teams) *

Sociable (accepted by others, not withdrawn or antisocial) *

Devotional Life (prayer, reflection, reading) *

Communication skills (able to share ideas effectively with others) *

Stewardship (tithing, generosity, honest gain) *

Convictions (commitment to beliefs) *

Adaptability (able to cope with changing situations) *

Tolerance (allows other points of view, patient) *

Tact (think before speaking, apply diplomacy) *

Christian experience (consecrated, gracious, knowledgeable in Christian matters) *

General health (reasonably fit and healthy in body and mind) *

Modesty (in behaviour and dress) *

59. Is there anything that you know about that could affect your status as a credentialed minister that the committee should be aware of that was not covered in any of the questions on this form? (if yes provide details)

Section 5: Referees

Please supply the details of three unrelated referees other than your coaching pastor.
Ask their permission prior to submitting this application and advise them they will receive a form to complete.
A referee form will be sent to them independently from the VICTAS Credential Office.

Referee 1

Full Name: *

Relationship to applicant: *

Daytime phone number: *

Email: *

Referee 2

Full Name: *

Relationship to applicant: *

Daytime phone number: *

Email: *

Referee 3

Full Name: *

Relationship to applicant: *

Daytime phone number: *

Email: *

Section 6: Declaration

I declare:

• All the information contained in this application is true and correct to the best of my knowledge

• I am fully aware of my responsibilities to CRC Churches International and will adhere to such

• I know of no such reason or circumstances that would contradict any principles, declared or inferred, as part of this application for a credential.

• I acknowledge that the act of submitting this application means that I agree to the above declaration.

Date of submission