Please read the clergy information form carefully and fill in the requested information. If we have any other questions after submission, we’ll be in touch. "*" indicates required fields This field is hidden when viewing the formNext Steps: Sync an Email Add-OnTo get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020/). Important: Delete this tip before you publish the form.About YouYour Name* Title Mr.Mrs.MissMs.Dr.Prof.Rev. First Middle Last Preferred nameYour Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Your Phone*Phone TypeMobileLandlineYour Email Address* Allergies/dietary restrictionsDate of Birth* MM slash DD slash YYYY Place of Birth*Date of Baptism* MM slash DD slash YYYY Place of Baptism*Date of Confirmation/Reception* MM slash DD slash YYYY Place of Confirmation/Reception*Date of Diaconate Ordination* MM slash DD slash YYYY Place of Diaconate Ordination*Date of Presbyteral Ordination MM slash DD slash YYYY Place of Presbyteral OrdinationCurrent Diocese*Length of time active in the above stated diocese (years/months) i.e. 7 years, 2 months*Allergies/dietary restrictions*Education/WorkName of high school, date of graduation and degree earnedName of college(s), date(s) of graduation and degree(s) earnedOther educational experience(s)Are you secularly employed? If yes, list role and companyEmergency Contact InformationName* Title Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Phone*Family InformationSkip if not applicableMarriage date MM slash DD slash YYYY Full name of spouse Prefix Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Spouse's email Spouse's preferred phoneName(s) and birthdate(s) of child(ren)CAPTCHANameThis field is for validation purposes and should be left unchanged.
