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Wherever the river flows there is life!
Ministerial
Credentials
Application
Handbook
Dale AdamsConference Superintendent
Email:bishop@rolmiphc.com
River of Life MinistriesConference
246. S. Mercer St.Greenville, PA 16125
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Dear Friend,
Thank you for your interest and desire to hold credentials in the River of Life Conference of the International Pentecostal Holiness Church. In order to hold credentials in this organization an individual most satisfactorily complete the application process as set forth by the Conference Executive Council and the conference ministerial credentials committee/board. This process is in place in order to provide opportunities for those who feel called and committed to service in Christ's kingdom, and to provide qualified "laborers in the harvest" (Matthew 9:38) in the local congregations of the conference.
Enclosed you will find the following materials. A check list is provided below to insure the proper completion of the application process.
1. Application Form. Please complete and return as soon as possible
2. Three evaluation forms. (pages 10-12 of this application) On each form you must either waive the right to examine or reserve the right to examine, then sign on line provided. Send one form to your local pastor. Send one form to a businessman/employer. Send one form to a person of your choice who is not related to you by family. Each of
these people will mail their evaluation directly to the address provided.
3. Please note that a formal academic degree is not required for credentials in the IPHC. You may send transcripts of any or all formal academic work completed that you feel have a bearing on your qualifications as an applicant for ministerial license. Please provide a catalogue, if available, from the given institution(s) for course descriptions.
4. If you or your spouse has experienced a divorce, please send a copy of your divorce decree.
5. The other items not included but considered essential reading are as follows:These items can be accessed on our website. Go to www.iphc.org. Under the "Who We Are"tab, click on IPHC Manual.1. Article IV of the Constitution - Articles of Faith2. Article VII of the Constitution - Covenant Commitment3. Article V of the Bylaws - Financial Guidelines4. This denomination has a prescribed course of study for ministerial credentials. A list of
book titles and/or classroom instruction which comprise a three year study course areavailable upon request. Courses from academic institutions may be accepted in lieu ofcourses in the required three year study course.
6. Mail entire application along with a check for $50.00. ($25.00 application fee and a $25.00fee for a criminal background check to:ROLM Conference246 S. Mercer St.Greenville, PA 16125
Thank you for your interest. May the Lord guide you and sustain you as you pursue your calling into ministry with the International Pentecostal Holiness Church.
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MINISTERIAL CREDENTIALS APPLICATION
River of Life Ministries Conference ofThe International Pentecostal Holiness Church, Inc.
246 S. Mercer St. Greenville, PA 16125Website: www.rolmiphc.com
Application for: Minister’s License Please
Local Church Ministers
Pastoral/Evangelist License
Ordination
check the
License
Discipleship Ministries License
Reinstatement
License and/or
Music Ministry License
Transfer (Must complete
Specialty
Module you
desire
entire application in addition to transferee’s
section, page 7)
Personal:
1. Full Name ______________________________________________________________________________________
Address ________________________________________________________________________________________
City ______________________________________ State _________________________ Zip ___________________
2. Phone: Home (_____)__________________; Office (_____)__________________; Cell (_____)_________________
3. E-mail address___________________________________________________________________________________
4. Date of Birth ___________________________ Place of Birth _____________________________________________
Nationality ________________________________
5. Sex: Male Female
6. Social Security No. ____________________________________
7.
Anniversary Date _____________________________________
8.
Current Marital Status Single Married Divorced * Widow/er
(* Please include a copy of the divorce decree and give details of divorce along with circumstances, use separate sheet
of paper.)
9.
Spouse’s Full Name _______________________________________________________________________________
10.
Spouse’s Date of Birth ____________________________
11. Do you/your spouse have any prior marriages? Yes No
* If yes, how was the marriage terminated? Divorce Widowed Annulment
12. Names and ages of children: _______________________________________________________________________
_______________________________________________________________________________________________
13. Give three references: Include (1) pastor, (2) a businessman, and (3) one other person not related.
(See Recommendation/Evaluation Form
Name Address City/State/Zip Phone
(1) ____________________________________________________________________________________________
(2) ____________________________________________________________________________________________
(3) ____________________________________________________________________________________________
Attach a recent
photograph of
yourself here
Specialty Module
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14. Have you ever been charged and/or convicted of a felony or misdemeanor (excluding minor traffic offenses)?
Yes No If yes, explain charge or conviction – use separate sheet of paper.
15. Have you ever been charged and/or convicted of child molestation, child abuse, assault, or sex offenses of any nature?
Yes No If yes, explain charge or conviction – use separate sheet of paper.
16. Have you ever had an extra-marital affair (sexual physical intimacy with another person outside the covenant of your
marriage)? Yes No If yes, explain – use separate sheet of paper.
17. The following questions are not intended to be overly intrusive, but rather, in a highly sensitive area, to clarify the
applicant’s qualifications to ministry. The committee responsible for screening applicants has determined the value of
these questions as appropriate in the interests of applicants’ full disclosure. If you answer “yes” to any of these
questions, please include a separate sheet of paper describing any counseling, or restoration programs you have
completed in response to these issues.
Have you ever been unfaithful to your spouse?
a. Physical affair with another person that involved touching even though not intimately sexual?
Yes No If yes, explain – use separate sheet of paper
b. Emotional affair with another person? By this we mean: obsession with someone outside the covenant of your
marriage involving inappropriate contact (phone, personal meetings, letters, e-mails, etc.) and time spent with that
person in inappropriate places (private settings, or questionable contexts or situations).
Yes No If yes, explain – use separate sheet of paper
c. Habituation to pornography or sexual fantasy?
Yes No If yes, explain – use separate sheet of paper
18. You are responsible for obtaining and including with this application the following:
1. Recent Photograph of yourself 2. Copy of current Driver’s License 3. Copy of tithing report for last year
Employment History: (Secular and Christian Service)
1. Current or last place of employment:Company/Church Name Phone #
Address Direct Supervisor
City/State/Zip Date of Employment
Job Title/Responsibility Annual Salary
2. Other Employment in the last ten years:Company/Church Name
1.
Job Title/Responsibility Salary Dates of Employment
2.
3.
4.
4. Current Credit Score______ Which reporting source did you use? ___ Experian ___ Equifax ___ TransUnion
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Education:
1. Circle highest grade/level completed
High School 8 9 10 11 12 Year Graduated ____________
College 1 2 3 4 (+) Year Graduated ____________
Graduate/Seminary 1 2 3 4 (+) Year Graduated ____________
2. List the Bible schools, colleges, or seminaries you have attended: give dates, courses completed and degrees earned
(Forward copies of transcripts to Conference Office)
_____________________________________________________________________________________________
_____________________________________________________________________________________________
3. Have you completed the International Pentecostal Holiness Church’s (IPHC) ministerial training course?
Yes ( First Year Second Year Third Year ) No
4. Have you had equivalent training (If yes, explain – use separate sheet of paper) Yes No
5. If deemed necessary, would you be willing to take additional training offered by the River of Life Conference? No
Christian/Church Experience:
1. When did you accept Jesus Christ as your personal Savior? _______________________________________________
2. Have you been baptized in water according to Matthew 28:19? Yes No
Yes No 3. Do you believe in sanctification as a instant event when you ask Jesus to forgive you ofyour sins as well as a lifelong process where we become more and more like Christ?
Please give a brief explanation if necessary ______________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
4. Have you been baptized with the Holy Spirit with the initial evidence of speaking with other tongues? (Acts 2:4)
Yes No
5. How long have you been a member of the IPHC? _______________________________________________________
6. Name of current church membership. ______________________________________________________________
7. Have you previously held credentials with the IPHC, or another denomination? Yes No
If yes, when/ with whom? _________________________________________________________________________
Local Church Minister Licensed Minister Ordination
Other _____________________________________________________________________________
8. Has your spouse held credentials with the IPHC, or another denomination? Yes No
If yes, when/ with whom? _________________________________________________________________________
Local Church Minister Licensed Minister Ordination Other ______________________
Yes
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9. Have you ever, for any reason, been dismissed from another organization or had your credentials revoked?
Yes No
If yes, explain, giving the name of the organization and the reason for dismissal. ______________________________
10. Do you know without a doubt that you are called into Christian ministry? Yes No
11. What is your ministry calling? Pastor Evangelist Teacher
Other (explain) _____________________________________________________________________
12. What type of ministry are you currently engaged? _______________________________________________________
Supervisor, if applicable ________________________________________________________________________
13. Give a brief summary of your experience in church leadership _____________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
14. If you are applying for a local church minister’s certificate, do you understand you are amenable to your pastor and
local church? Yes No
15. If you are applying for a license other than a local church minister’s certificate, do you understand you are amenable to
the quadrennial conference and the conference board? Yes No
16. Are you a faithful and consistent tither? (If No, please explain on a separate paper) Yes No
17. Will you take advantage of the opportunities made available for training, instruction, information and inspiration?
(i.e continuing educational programs for ministers) Yes No
18. Have you read the Bible through at least once? Yes No
19. Do you believe the Bible to be the inerrant Word of God? Yes No
20. Have you read the IPHC 2009-2013 Manual? Yes No
21. Are you in agreement with the Articles of Faith of the IPHC? Yes No
22. Are you in agreement with the Covenant of Commitment of the IPHC? Yes No
23. Will you cooperate with the denominational programs at the local, conference and general levels and lead your people
by example. (This includes reporting systematically and consistently on forms provided.) Yes No
24. Will you be faithful to the sacred trust of the ministry by diligence, by uprightness in business matters, by ministerial
ethics and courtesy, by self sacrifice, by purity, by avoiding the very appearance of evil, by cherishing the anointing of
the Holy Spirit, even unto death? Yes No
25. If you reach a place where you are out of harmony with the ministry vision of the IPHC, will you surrender your
license/ordination certificate to your conference superintendent? Yes No
26. Why do you want to pursue ministerial credentials and how will this help you accomplish your goals? ___________________________________________________________________________________________________________________________________________________________________________________________________________
* Shaded items must be included with submitted application
_________________________________________________ _________/________/________
Signature of Applicant Date of Application
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* Note: If not a transfer of credentials, skip the following section and proceed to the next section
below.
FOR TRANSFERS ONLY:
Transferring from what denomination/fellowship
Current position/place of ministry
Supervisor if applicable Phone #
Other positions held: Senior Pastor Missionary Church staff Evangelist
Bible College Instructor Other (explain)
************************************************************
INFORMATION AUTHORIZATION AND RELEASE
I, the undersigned, having filed an application for credentials with the River of Life Conference (herein referred to as
“Conference”) of the International Pentecostal Holiness Church consent to have an investigation made as to the conduct of
my personal affairs, my moral character, professional reputation, fitness for the ministry, and such further information as
may be received by or reported to the above-named Conference. I agree to give any further information which may be
required in reference to my past history.
I authorize and request every person, firm, company, corporation, governmental agency, court, association, church,
educational facility, or institution having control of any documents, records, and other information pertaining to me to
furnish to the Conference of the International Pentecostal Holiness Church any such information, including documents,
records, or other information regarding charges or complaints filed against me, formal or informal, pending or closed, and
to permit the above-named Conference or any of its agents or representatives to inspect and make copies of such
documents, records, and other information.
I hereby release, discharge, and exonerate the Conference of the International Pentecostal Holiness Church, its agents and
representatives and any person furnishing information from any and all liability of every nature and kind arising out of the
furnishing or inspection of such documents, records, and other information or the investigations made by or on behalf of the
above-named Conference. The Conference of the International Pentecostal Holiness Church shall not be required to verify
any information received during the course of its investigations, and shall not be liable for acting on the basis of any
information which later appears to have been false or incomplete.
I have read and signed the foregoing Authorization and Release as my own free act and deed.
____________________________________________
Signature
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Church Knights
Information/Verification Release Form
Employee/Applicant Full Name: ___________________________________________________
PLEASE PRINT
Complete Current Address: _______________________________________________________
SSN: __________________________ Current Phone Number ___( __ )_________________
AUTHORIZATION AND RELEASE
I, ___________________________________________________ having filed an application with the River of Life Ministries Conference of the International Pentecostal Holiness Church do hereby request and consent to have an
investigation made as to my character, professional reputation, and general fitness for the position I have applied for, now
or at any time during my employment, and to verify the accuracy of the information supplied on my application, and such
other information as may be received, all of which will he reported to my prospective employer,
I hereby agree to give any further information, which may be required, concerning my past record. I understand that the
contents of my background report are confidential. I will be given a copy if I so request.
I also authorize, and request, every person, firm, company, previous employer, corporation, governmental agency, law
enforcement agency, court, association or institution having control of any documents, records or other information
pertaining to me, to furnish to Pasquale Imbimbo, Church Knights, as agent for my prospective employer, any such
information, including documents, records, and files, whether formal or informal, pending or closed, or any other pertinent
data; and to permit my prospective employer, or any of its agents or representatives to inspect and make copies of such
documents, records, files or other information.
I also understand and agree that neither my employer, nor its agent(s), is responsible for the accuracy of the content of any
records located by, or delivered to, them by any entity.
I hereby release, hold harmless, discharge and exonerate its agents or representatives and any person, so furnishing
information, from any and all liability, of every nature and kind, arising out of the furnishing or inspection of such
documents, records, files and other information or the investigation made by Pasquale Imbimbo, Church Knights or it’s
agents.
I have read the foregoing document and I have answered all questions with respect to my application for a background
report fully and frankly. The answers are complete and true and I affix my signature hereto freely and voluntarily.
Copies of this document shall carry the same authority as the original.
____________________________________ ____________ ________________________________
Applicant Signature Date Witness/Employer.
ATTENTION: The Global Ministry Center Department Director or Supervisor, Conference Bishop, Church Pastor
or Administrator is responsible and required to maintain this document on file as per the usage agreement with
Pasquale Imbimbo, Church Knights. A separate document needs to be generated for each background check
requested.
ATTENTION: For the purpose of this document, employment means, paid or unpaid employment, full-time or part-
time, volunteer or employee.
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Applicant for Ministerial License Reference River of Life Ministries
International Pentecostal Holiness Church (Employer/Businessman)
has applied for ministerial credentialing with River of Life Ministries of theInternational Pentecostal Holiness Church. The Conference Board and Ministerial Credentials Committee would appreciate your frank and unbiased estimate of this applicant as a potential minister of the Gospel of Jesus Christ, holding credentials in this organization. Under law, the applicant may examine this evaluation in his/her file any time, unless the applicant waives the right to review this evaluation.
( ) I waive my right to review or examine this evaluation, and your comments will be treated confidentially.
Signed:
( ) I reserve the right to examine this evaluation.
Signed:
Evaluation
How long have you known the applicant?
In what capacity?
To your knowledge, has the applicant lived a consistent Christian life? If not, please explain; use the opposite side of this sheet if necessary.
Please give your evaluation of the applicant by rating him/her on the following items (1 being worst, 5 being best):
Would you recommend this applicants ministerial character without reservation? Please use the opposite side of this sheet if necessary.
Signed Position/Occupation
Address
Date
Seriousness of Purpose 1 2 3 4 5
Self-Motivation 1 2 3 4 5
Concern for others 1 2 3 4 5
Emotional stability 1 2 3 4 5
Ministerial potential 1 2 3 4 5
Personality 1 2 3 4 5
Honesty 1 2 3 4 5
Family Relationships 1 2 3 4 5
Morality 1 2 3 4 5
Telephone:
This is a confidential referral. Please remit directly to:River of Life Ministries
246 S. Mercer St. Greenville, PA 16125
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Applicant for Ministerial License Reference River of Life Ministries
International Pentecostal Holiness Church (Friend)
has applied for ministerial credentialing with River of Life Ministries of theInternational Pentecostal Holiness Church. The Conference Board and Ministerial Credentials Committee would appreciate your frank and unbiased estimate of this applicant as a potential minister of the Gospel of Jesus Christ, holding credentials in this organization. Under law, the applicant may examine this evaluation in his/her file any time, unless the applicant waives the right to review this evaluation.
( ) I waive my right to review or examine this evaluation, and your comments will be treated confidentially.
Signed:
( ) I reserve the right to examine this evaluation.
Signed:
Evaluation
How long have you known the applicant?
In what capacity?
To your knowledge, has the applicant lived a consistent Christian life? If not, please explain; use the opposite side of this sheet if necessary.
Please give your evaluation of the applicant by rating him/her on the following items (1 being worst, 5 being best):
Would you recommend this applicants ministerial character without reservation? Please use the opposite side of this sheet if necessary.
Signed Position/Occupation
Address
Date
Seriousness of Purpose 1 2 3 4 5
Self-Motivation 1 2 3 4 5
Concern for others 1 2 3 4 5
Emotional stability 1 2 3 4 5
Ministerial potential 1 2 3 4 5
Personality 1 2 3 4 5
Honesty 1 2 3 4 5
Family Relationships 1 2 3 4 5
Morality 1 2 3 4 5
Telephone:
This is a confidential referral. Please remit directly to:River of Life Ministries
246 S. Mercer St. Greenville, PA 16125
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Applicant for Ministerial License Reference River of Life Ministries
International Pentecostal Holiness Church (Local Pastor)
has applied for ministerial credentialing with River of Life Ministries of theInternational Pentecostal Holiness Church. The Conference Board and Ministerial Credentials Committee would appreciate your frank and unbiased estimate of this applicant as a potential minister of the Gospel of Jesus Christ, holding credentials in this organization. Under law, the applicant may examine this evaluation in his/her file any time, unless the applicant waives the right to review this evaluation.
( ) I waive my right to review or examine this evaluation, and your comments will be treated confidentially.
Signed:
( ) I reserve the right to examine this evaluation.
Signed:
Evaluation
How long have you known the applicant?
In what capacity?
To your knowledge, has the applicant lived a consistent Christian life? If not, please explain; use the opposite side of this sheet if necessary.
Please give your evaluation of the applicant by rating him/her on the following items (1 being worst, 5 being best):
Would you recommend this applicants ministerial character without reservation? Please use the opposite side of this sheet if necessary.
Signed Position/Occupation
Address
Date
Seriousness of Purpose 1 2 3 4 5
Self-Motivation 1 2 3 4 5
Concern for others 1 2 3 4 5
Emotional stability 1 2 3 4 5
Ministerial potential 1 2 3 4 5
Personality 1 2 3 4 5
Honesty 1 2 3 4 5
Family Relationships 1 2 3 4 5
Morality 1 2 3 4 5
This is a confidential referral. Please remit directly to:River of Life Ministries
246 S. mercer St. Greenville, PA 16125
Telephone:
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