Name
Spouse (if applicable)
Home phone
Cell phone
Your Email
Home address
Member of ________ Covenant Church
Age (optional) 20-29 30-39 40-49 50-59 60+
Ethnicity (optional)
Conference Canada Central East Coast Great Lakes Midsouth Midwest North Pacific Northwest Pacific Southwest Southeast ECCAK (Alaska)
Please choose the board(s) you are interested in Executive Board Nominations Ordered Ministry Pensions and Benefits Women Ministries Benevolence North Park University Annual Meeting Moderator/Vice-Moderator Annual Meeting Secretary/Vice-Secretary
I have gifts/interests in the boards I selected because
Personal statement of faith in Jesus Christ
Present occupation (job title)
Years in job
Firm and location
Responsibilities, leadership roles, specific skills gained at this profession
Significant previous occupation(s)
Covenant denominational boards, committees, commissions, etc. (denominational involvement)
Covenant conference boards, commissions, task forces, consulting roles (conference involvement)
Ecumenical leadership roles (city-wide church associations, involvement with other denominations, etc.)
Church council involvement (past and present) Chairperson Vice-chair Secretary Treasurer Member
Sunday school teacher (past and present) Adult College High school Middle or junior high Elementary Preschool
Other significant local church leadership roles/involvement
High school Trade College Masters Doctorate License Certification Other
Graduate major field and school
Additional classes, training, seminars, interests, or skills that you would like to be noted
(Trustee of a hospital, foundation, or museum; Rotary; volunteer; honors/awards, etc.)
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