Name: ______________________________________ Date of Birth ______/______/_______
Student: ☐ No ☐ Yes College/University/Seminary Attending _____________________
Gender: ☐ Male ☐ Female Expected Graduation Date _______/_______/_________
Preferred Address: _____________________________________________________________
City: ________________________________ State ______________ ZIP: _________________
Preferred Contact Info: Phone ____________________ Email: __________________________
Home Church: __________________________________ District: _______________________
☐This will be my first time taking a psychological assessment for The United Methodist
Church. If not, please indicate when and where you completed a psychological
assessment. _____________________________________________________________
☐I have read the Certified Candidacy Process guide included in this packet.
☐I have completed (am in the process of completing) The Christian as Minister with:
Rev. ________________________________________________ on ___/___/___
Clergy Leader’s Signature: _______________________________________
Clergy Leader’s Phone: _____________________ Email: _________________________
☐I have met with my District Superintendent
__________________________________________ _________________________
District Superintendent Date
Michigan Conference Candidacy Summit Application
Candidacy Summit – Friday & Saturday, January 28 & 29, 2022
Payment and Application Due: December 1, 2021
All other paperwork due: January 1, 2022
Mail completed, signed application and payment to:
Michigan Conference Center
Debbie Stevenson
Coordinator, Board of Ordained Ministry
1011 Northcrest Rd.
Lansing, MI 48906
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