Clergy/Nominee Information Form

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

URL

This field is for validation purposes and should be left unchanged.

This field is hidden when viewing the form

Next Steps: Sync an Email Add-On

To 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 You

Your Name*

Title First Middle Last

Preferred name

Your Address*

Street Address City State ZIP Code

Your Phone*

Phone Type

Your Email Address*

Allergies/dietary restrictions

Date of Birth*

Place of Birth*

Date of Baptism*

Place of Baptism*

Date of Confirmation/Reception*

Place of Confirmation/Reception*

Date of Diaconate Ordination

Place of Diaconate Ordination

Date of Presbyteral Ordination

Place of Presbyteral Ordination

Current Diocese*

Current Congregation:

Length of time active in your current diocese (years/months) e.g. 7 years, 2 months*

Length of time active in your current congregation (years/months) e.g. 7 years, 2 months

If in the discernment process, have you ever previously applied or been nominated for the ordination process?

Yes

Please upload a photo of yourself

Max. file size: 128 MB.

Education/Work

Name of high school, date of graduation and degree earned

Name of college(s), date(s) of graduation and degree(s) earned

Other educational experience(s)

Are you secularly employed? If yes, list role and company

Emergency Contact Information

Name*

Title First Last

Phone*

Family Information

Skip if not applicable

Marriage date

Full name of spouse

Prefix First Last

Spouse's email

Spouse's preferred phone

Name(s) and birthdate(s) of child(ren)

Clergy/Nominee Information Form

Next Steps: Sync an Email Add-On

About You

Education/Work

Emergency Contact Information

Family Information

Previous PostEucharistic Visitor Application

Next PostBackground Information Release Form

About

News & Events

Resources & Administration

Annual Convention