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Application to Direct
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We are honored you would like to work with us in reaching students for Christ on the campus through leading a Chi Alpha group. Please take your time to complete the following application. We will be in contact with you after you have submitted your application about next steps in our placement process.
Personal Information
Name
*
First
Last
Email
*
Date of Birth
*
MM slash DD slash YYYY
Are you currently an affiliated leader with Chi Alpha through the National Chi Alpha Ministry Center?
*
Yes
No
What is the name of the campus you are applying to direct/pioneer?
*
Please write out the full name of the college/university. Abbreviations are not clear enough to determine the name as there can be several colleges/universities with the same acronym.
What is the city and state of the campus you are applying to direct/pioneer?
City
State / Province / Region
Marital Information
*
Please check all that apply.
Single
Engaged
Married
Married with children
Widowed
Divorced or annulled marriage
Other
Other
*
If divorced or if your marriage has been annulled, please explain.
*
Fiancé(e)/Spouse Name
*
First
Last
Please list your children's names and ages.
*
If you do not have children, please put N/A.
Highest level of education
*
High school or GED
Some college
Associate's degree
Bachelor's degree
Master's degree
Doctorate
List the degree(s) you currently hold and the instituted from where it was received.
*
Click the plus sign on the right to add a new row.
Please write out the full name of the college/university. Abbreviations are not clear enough to determine the name as there can be several colleges/universities with the same acronym.
Degree
Institution
Spiritual and Ministry Experiences
What year did you come to Christ?
*
What year were you water baptized?
*
What year were filled with the Holy Spirit?
*
What is the highest level of ministerial credentials you have received from the Assemblies of God.
*
If you hold credentials from another denomination, please select “other.”
None
Certified minister
Licensed minister
Ordained minister
Other
What other credentials do you hold?
What district holds your credentials?
*
Alabama
Alaska
Appalachian
Arizona
Arkansas
Brazilian
Central
Central Pacific
Florida Multicultural
Georgia
German
Hawaii
Illinois
Indiana
Iowa
Kansas
Kentucky
Korean
Louisiana
Michigan
Midwest Latin American
Minnesota
Mississippi
Montana
National Slavic
Nebraska
New Jersey
New Mexico
New York
North Carolina
North Dakota
North Texas
Northern California-Nevada
Northern Missouri
Northern New England
Northwest
Northwest Hispanic
Ohio
Oklahoma
Oregon
Peninsular Florida
Pennsylvania-Delaware
Potomac
Puerto Rico
Rocky Mountain
Somoan
Second Korean
South Carolina
South Central Hispanic
South Dakota
South Texas
Southeastern Spanish
Southern California
Southern Idaho
Southern Latin
Southern Missouri
Southern New England
Southern Pacific
Southwest
Spanish Eastern
Tennessee
Texas Gulf Hispanic
Texas Louisiana Hispanic
West Florida
West Texas and Plains
West Texas
Wisconsin-Northern Michigan
Wyoming
Have you ever had your credentials suspended or revoked?
*
No
Yes
Please give the reason, date reinstated, and district in which suspension occurred.
*
Check all that apply to your previous Chi Alpha experience(s).
*
Involved as an undergraduate
Student leader in Chi Alpha
Volunteered with a local Chi Alpha chapter
Attended a local or district-wide retreat
Attended SALT
Participated in a Chi Alpha missions trip
Attended The World Missions Summit
Attended SICM
Attended LIGHT or INCITE
Served as an associate staff (missionary associate) having raised a missionary budget
Attended Reach the University Institute (RUI)
Completed Pioneering Boot Camp
Served as a church volunteer leading a Chi Alpha or college ministry
Served as a leader of a local Chi Alpha or college ministry as staff of a local church
Attended RUI
Other
Other
*
Have you completed a Chi Alpha CMIT program?
*
Yes
No
What CMIT program did you complete?
*
Please write out the full name of the college/university where the program was located. Abbreviations are not clear enough to determine the name as there can be several colleges/universities with the same acronym.
List any ministry training you've received beyond what was referenced above.
Background and Job History
List your last three jobs with start and end dates. Include job title, major responsibilities, and number of direct reports that worked under you for each position.
*
Click the plus sign on the right to add rows.
Name of Employer
Dates Employed
Job Title
Job Responsibilities
Number of Direct Reports
Have you ever been discharged or asked to resign from any job or ministry position?
*
No
Yes
Please explain.
*
Have you ever been convicted of or pled guilty to a violation of any law or ordinance?
*
No
Yes
Please explain.
*
Are you currently a Chi Alpha missionary?
*
This includes missionary associate, CMIT, or give-a-year.
Yes
No
How many years have you served in your current role?
*
Have you served as a director, lead pastor, or a similar position in ministry?
*
Yes
No
How long have you served as a director, lead pastor, or a similar position in ministry?
*
Less than 3 years
3 to 5 years
More than 6 years
How many paid staff did you oversee?
*
1 to 3 paid staff
4 to 6 paid staff
More than 7 paid staff
Other
How many years have you served in an missionary associate, CMIT, give-a-year, youth pastor, or similar role?
*
None
Less than 3 years
3 to 5 years
More than 6 years
Are you coming to Chi Alpha from the marketplace?
*
No
Yes
In your last position, how many people were direct reports under you?
*
None
1 to 3 employees
4 to 6 employees
More than 7 employees
Ministry and Leadership Experiences
This section helps us understand your ministry skills and experiences up to this point. Please be as honest as possible when answering the following questions. We are not a hiring agency, so your answers will not be used to determine your ability to serve in your desired role. However, your answers will be used to develop a learning plan if you are accepted into the Director Training Program.
Have you gone through the Pioneering Assessment (Ministry Planter Profile)?
*
Here can find more information about the assessment
here
.
Yes
No
Other
Other
*
Please forward your results to
Delyn Cole
.
Thinking back over the last 3 years, how many "projects" have you started from scratch through completion that were your own idea?
*
When we say projects, this may include new ministries, business endeavors, or a small group. Here’s the catch: we are looking for your ideas, not an idea delegated to you.
None
1
2 to 3
3 to 5
More than 5
Other
Please describe.
*
Rate yourself on your ability to self manage multiple projects without direct supervision.
*
1 = Works best with direct supervision
6 = Able to handle multiple projects without supervision
1
2
3
4
5
6
How many people have you been able to identify, recruit, and equip to serve in a leadership role over the last 3 years?
*
None
1 to 2
3 to 4
5 to 6
More than 7
Other
Other
*
How many friends have you been privileged to lead to a commitment to Christ over the past 3 years?
*
Please only include those you’ve had a friendship with and not those that you may have been able to pray with in a ministry context that you had not known previously.
None
1 to 2
3 to 4
5 to 6
More than 7
Other
Other
*
Share with us how your spouse has confirmed that he or she is on board with your new role as directing/pioneering this chapter of Chi Alpha.
*
How many friends would you say that you have that would be considered "lifelong friends?" This is the kind of friend you've known for more than 5 years and have had a period of distance or even a disagreement at one point but are now on great terms.
*
None
1 to 2
3 to 5
More than 6
Other
Other
*
In your last ministry role, were you able to strategically grow the ministry?
*
Yes
No
N/A
Other
Other
*
Think back to the last community outreach you led. Briefly describe it and the target audience. If it was an ongoing event, how did you make adjustments to reach new people for the event.
*
Finish the following statement: The way I generally know if someone is gifted for a specific ministry is by ….
*
Rate yourself on your ability of sticking with a plan and making changes.
*
1 = When I have a plan, I stick to it until it works.
6 = I am quick to make adjustments to a “plan” if it is not working.
1
2
3
4
5
6
What happened with the last small group you started?
*
Choose the answer that most closely fits.
The group grew strong together and did not multiply.
The group grew strong together, multiplied but one of the two groups fell apart after starting.
The group grew strong together, multiplied and both groups were thriving 6 months later.
The group struggled to ever grow strong together.
I wasn't able to gather enough people to get the group started.
I have never led a small group.
Other
Other
*
Rate your calling to be a Chi Alpha director/pioneer on the following scale:
*
1 = I am happy to lead but would be just as happy to be on a team.
6 = I feel called to be the director/lead and build a team under me.
1
2
3
4
5
6
When thinking back on your last major setback or loss in life, how long did it keep you from normal activity?
*
Less than a month
1 to 3 months
4 to 6 months
7 months to a year
1.5 to 2 years
More than 2 years
Other
Other
*
What is the craziest leap of faith you have taken in life?
*
Over the last 3 years, how many people would call you their mentor or similar role in their life?
*
None
1 to 2
3 to 4
5 to 6
More than 7
Of those you mentored these last 3 years, what is the average number of people they are mentoring?
*
None
1 to 2
3 to 4
5 to 6
More than 7
Unknown
List your top 3 strengths.
*
List 3 weaknesses.
*
In a sentence, what is your life mission?
*
Typically in ministry we see people fall in one of three categories: 1) The "crowd," which is the total number who attend or are involved, 2) a committed "community," which are those who are normally at the main meeting, and 3) a "core," which are those who are deeply committed to the ministry function. In your last ministry role, please give us these breakdown of these three categories.
*
For example, if you led a worship team, let us know the total number of worship team members, your main worship team numbers and team leaders.
What is your top leadership book that you've implemented in your last leadership role?
*
Which statement best describes how you typically work through a major problem?
*
Select All
I research options to solve the problem and implement with a clear goal.
I ask my “mentor” for advice and ask them to help me through it.
I go to an expert that I may or may not know and get input.
I pull together those closest to me and together we develop a solution.
I don’t necessarily build a plan but work through it one day at a time.
Other
Other
*
What is your go-to Scripture when sharing Jesus with a pre-Christian?
*
How often do you communicate with your supporters?
*
Once a year
Twice a year
Quarterly
Monthly
Multiple times a month
N/A
How many new supporters have joined your support team over the last 3 months?
*
None
1 to 3
4 to 6
More than 7
N/A
Which statement closest describes how you budget and set financial goals?
*
I don't have a defined budget or a savings goal.
I have a clear budget that I monitor at least monthly.
I have made a plan and generally follow it but not monthly.
Because my budget fluctuates so often, I do not have a budget but manage to stay ahead of my bills.
This is a consistent area of stress for me.
Do you faithfully tithe?
*
Yes
No
Other
Other
*
How many missionaries do you currently support each month?
*
None
1 to 3
3 to 6
7 to 10
More than 11
Do you have consumer debt?
*
Include credit card, car loans, school loans, and second mortgages.
Yes
No
How much consumer debt are you paying off?
*
How confident would you be in managing a ministry budget of $250,000?
*
1 = uncomfortable
6 = extremely confident
1
2
3
4
5
6
List up to three cross-cultural mission trips or outreaches you've participated in.
*
Trip or Outreach
Dates
Role on the Team
Over the last 3 years, how many people have you prayed with to receive the baptism in the Holy Spirit?
*
None
1 to 5
6 to 10
11 to 15
More than 20
Other
Other
*
Who is a key influence in your theological perspective?
*
List the book you last recommended to someone with a major theology inquiry.
*
References
By giving us the following information, you agree that we may contact the following references and follow up on information shared with us.
Pastor Name
*
First
Last
Pastor Cell Phone
*
Pastor Work Phone
Pastor Email
*
Are you related to the pastor?
*
Yes
No
Do you have a CMIT director to use as a reference?
*
Yes
No
CMIT Director Name
*
First
Last
CMIT Director Cell Phone
*
CMIT Director Work Phone
CMIT Director Email
*
CMIT Director's relationship to you
*
Employer Name
*
Please choose an employer you’ve had in the last 5 years.
If your last employer was the pastor listed above, please list the previous employer.
First
Last
Employer Cell Phone
*
Employer Work Phone
Employer Email
*
Direct Report Name
*
Please choose someone you’ve overseen in the last 3 years.
First
Last
Direct Report Cell Phone
*
Direct Report Work Phone
Direct Report Email
*
Would you like to include a mentor as a reference?
*
Yes
No
Mentor Name
*
First
Last
Mentor Cell Phone
*
Mentor Work Phone
Mentor Email
*
Would you like to include a lifelong friend as a reference?
*
Yes
No
Lifelong Friend Name
*
First
Last
Lifelong Friend Cell Phone
*
Lifelong Friend Work Phone
Lifelong Friend Email
*
By completing this application you agree to allow us to conduct a criminal background check and credit report with the information you have entered.
The information you’ve shared with us will be held confidentially within the leadership of Chi Alpha and will not be shared outside those responsible for the approval process including members of the district Chi Alpha committee, Chi Alpha area directors, and national Chi Alpha leadership.
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