American Baptist Churches of the Rocky Mountains :: Ordination Application, Self-Disclosure, and Release Form

••••••• Application, Self-Disclosure, and Release Form •••••••
for All Candidates Seeking Ordination

Full Name:

Address:

City:

State:

Zip:

Email address:

Phone number:

$100, payable to ABCRM is payable online through PayPal. Once your application has been submitted you will be given a link to make your payment. Applications will not be processed until this fee is received. When it is received, the Region office will contact you to initiate your background check.
(Click here to view sample background investigation authorization form.)

Ordination you are seeking:

Are you seeking chaplaincy credentials?

Yes No

1. List college or under-graduate degrees. Give date for each.

2. List seminary or other theological education. Gives dates.

3. Have you completed an American Baptist History and Polity Course at a Seminary?

Yes No (If “yes,” give name of school.):

4. Have you served as a pastor, interim pastor, associate or assistant pastor in the American Baptist Churches USA?

Yes No (If “yes,” state which and describe when and where.):

5. Have you served as a pastor, interim pastor, associate or assistant pastor in another denomination?

Yes No (If “yes,” state which and give dates.):

6. Please provide a brief statement which describes why you are pursuing the category of ordination indicated at the beginning of this form.

7. Give reasons why you feel you would like to minister in the American Baptist Churches USA.

Self-Disclosure Form

Each person having received or anticipating a call to a position with ABCRM is required to sign this “Self-Disclosure and Release Form” as a part of the process. Others already within the Region may be asked to sign this form when moving to a new location. The completed form should be given to the Region Office. ABCRM has an outstanding record for maintaining the highest moral and ethical standards in the practice of ministry. This record of service reflects our commitment to “preserve the dignity, maintain the discipline, and promote the integrity of the vocation to which we have been called” (The Covenant and Code of Ethics for Ministerial Leaders of American Baptist Churches). When any professional church leader engages in misconduct, the name of Christ is dishonored, the Church is brought into disrepute, and all involved suffer. In addition, there can be legal repercussions from such acts of misconduct. Therefore, ABCRM is committed to taking any reasonable precaution to avoid such disrepute, suffering, and litigation. This Self-Disclosure and Release Form is a part of the Region’s ministry. Your understanding and cooperation are deeply appreciated.

Mark “T” for True; “NT” for Not True

1.	I have never been the subject of official disciplinary proceedings in the ABCUSA or any other denomination or independent group that resulted in any of the following:	T	NT
	a. Censure
	b. Suspension of recognition of ordination
	c. Withdrawal of recognition of ordination.
2.	No official disciplinary proceedings within the ABCUSA or any other denomination or independent group are pending against me at this present time.
3.	No civil lawsuit alleging actual or attempted sexual harassment, exploitation, or abuse; or financial misconduct has ever been successfully prosecuted against me, settled out of court, or dropped because the statute of limitations had expired.
4.	My driver’s license has never been suspended or revoked due to reckless driving, driving while intoxicated, or driving under the influence of a controlled substance.
5.	I have never been found guilty or pleaded guilty or no contest to felony or misdemeanor charges or had felony or misdemeanor charges dropped because the statute of limitations had expired.
6.	My employment has never been terminated for actual or attempted sexual harassment, exploitation, or abuse; discrimination; physical abuse; child abuse; spousal abuse; or financial misconduct by me; nor have I terminated my employment primarily to avoid facing such charges or to avoid being terminated because of such charges.
7.	I know of no facts or circumstances regarding my background that would warrant further review of my fitness for ministry before my being entrusted with the responsibilities of ministry on behalf of a calling body within this Region.
8.	I have completed specific training in clergy ethics (including a review of procedures for handling allegations of pastoral misconduct).
9.	If I have not completed specific training in clergy ethics, or it is determined the training I did receive was not sufficient, I commit myself to complete such training within one year of accepting a position within this Region.
If you answered 'NT' to any of the above questions, please provide an explanation below. Remember to reference the applicable question number(s).

10. In addition to the names used on this form, as an adult, I have been known by the following name(s) during the time(s) indicated:

Release Form

By selecting this box I agree to the following:

This information I have provided on this application is accurate to the best of my knowledge and may be verified by the Region. I hereby authorize ABCRM to make any and all contacts necessary to verify my prior employment history, and to inquire concerning any prior arrest or criminal records or any professional, religious, or judicial proceedings involving me as a defendant. By means of this release, I also authorize any previous employer(s), religious judicatory, and any law enforcement agencies or judicial authorities to release any and all requested information to the Ministerial Leadership Committee of the American Baptist Church of the Rocky Mountains.

I have read this release and understand fully that the information obtained may be used to deny me acceptance by a calling body within the ABCRM or the recognition of my ordination by the Region. I also agree that I will hold harmless ABCRM, as well as any prior employer, religious judicatory, law enforcement authority, or judicial authority from any and all claims, liabilities, and cause of action for the release of the use or any information.

••••••• Application, Self-Disclosure, and Release Form ••••••• for All Candidates Seeking Ordination

••••••• Application, Self-Disclosure, and Release Form •••••••
for All Candidates Seeking Ordination