CMIT Program Application

A non-refundable application fee of $100 must accompany this application. Should your application and program be approved this fee will satisfy your first year’s program fee with national approval as a CMIT program. (Pay here.)
Personal Information
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Cell Phone*
Email*
Age*
Marital Status*
Provide information if you have been if you have been separated, divorced, remarried, or widowed.
Fiancé/Fiancée Name*
First Last
Spouse Name*
First Last
Wedding Anniversary*
MM slash DD slash YYYY

Save and Continue Later

Educational Background
College/University Name for Highest Degree Earned*
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.
College/University Location*
City State / Province / Region Country
Dates Attended College/University*
Degree Acquired*
GPA*

Save and Continue Later

Ministry/Ministerial Background
Do you currently hold ministerial credentials with the Assemblies of God?*
- Yes
- No
What date and where did you receive your ministerial credentials?*
Credentials Date District
What district council presently holds your ministerial credentials?*
Would you be willing to apply for ministerial credentials?*
- Yes
- No
Describe when and where you were converted to Christ.*
Have you been baptized in water by immersion?*
- Yes
- No
Have you received the Baptism in the Holy Spirit with the evidence of speaking in tongues?*
- Yes
- No
What biblical and theological education have you had to date (formal and informal)?*
List five books and/or periodicals you read recently that made an impression on you.*
Title Author

Save and Continue Later

Campus Missionary Finances
Do you give full-time focus to campus ministry (no outside employment)?*
- Yes
- No
Please describe type of outside job and number of hours per week.*
Is your personal missionary budget fully raised?*
- Yes
- No
What is your total financial compensation for ministry (including benefits, not including outside employment)?*
Please enter the amount in dollars.
Who determined or set this budget?*
First Last
Is your personal missionary budget adequate and appropriate (according to your estimation)?*
- Yes
- No

Save and Continue Later

The Local Chi Alpha Campus Ministry
Campus Name*
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.
How long has this Chi Alpha campus ministry been in existence and nationally chartered with Chi Alpha?*
How many total students are involved in discipleship groups in your campus ministry?*
Use the past semester/quarter as a guide.
How many total students attend the main weekly meeting?*
Does your Chi Alpha actively participate in mission trips?*
- Yes
- No

Save and Continue Later

Essay Questions/Responses
How long have you been involved in campus ministry at the staff level? Do not include years as a student leader.*
Are you in agreement and compliance with the Statements of Vision, Mission, Faith, Relationship, and Financial Responsibility as articulated on the Chi Alpha Leader Affiliation form?*
- Yes
- No
Do you give half tithes to nationally Chi Alpha personally?*
- Yes
- No
Does your group contribute to the national Chi Alpha program?*
- Yes
- No
How much has been given in tithes and group contributions over the past year?*
Describe how you participate in district, regional, and national Chi Alpha events.*
Describe how you were mentored and what evidence of mentoring skills you possess.*
Did you successfully complete a national approved CMIT program? If so, when and where and under whom? If never, how were you trained in campus missions?*
What is your process or system for discipleship student leadership development?
How is your local Chi Alpha campus ministry implementing the four priorities of Chi Alpha: healthy leaders, Holy Spirit Empowerment, cross cultural missions & disciple making groups?
Why do you desire to offer a nationally approved CMIT program? How would a CMIT program under your direction contribute to the national Chi Alpha campus ministry vision?*
What impact on your present Chi Alpha campus group do you anticipate the addition of a CMIT program will have?*
List other campus ministry staff person(s) who work alongside you. Describe in detail their status according to full-time and/or part-time. Also identify their primary areas of responsibility. How are they compensated, and how much is their total compensation? Which of these will be directly involved in providing leadership in a CMIT program?*
Describe your personal outreach and ministry to international students. How is your campus ministry involved with them? How many were involved with your group this past semester/quarter? How many international students attend your college/ university?*
Describe how you relate to the Assemblies of God on the local level and district level. Do you annually affiliate as a missionary leader with national Chi Alpha Campus Ministries, U.S.A?*
References
District Chi Alpha Director or Representative*
First Last
District Chi Alpha Director or Representative Email*
Chi Alpha Area Director*
First Last
Chi Alpha Area Director Email*
Local Senior Pastor of the Church You Attend*
First Last
Local Senior Pastor Email*
Primary Student Leader*
First Last
Student Leader Email*
Additional Primary Student Leader*
First Last
Student Leader Email*
Your next reference may be either a District Superintendent, District U.S. Missions Director, or District Youth Director. Please select one.*
District Superintendent*
First Last
District Superintendent Email*
District U.S. Missions Director*
First Last
District U.S. Missions Director Email*
District Youth Director*
First Last
District Youth Director Email*
A non-refundable application fee of $100 must accompany this application. Should your application and program be approved this fee will satisfy your first year’s program fee with national approval as a CMIT program. (Pay here.)
CAPTCHA

Save and Continue Later

Step 1 of 6

Personal Information

Educational Background

Ministry/Ministerial Background

Campus Missionary Finances

The Local Chi Alpha Campus Ministry

Essay Questions/Responses

References

Find A Chi Alpha Group Near You

Credentials	Date	District

Title	Author