Church Planter Application Name* Email* Phone* Address* Date of Birth* Marital Status* Married Single Spouse Name Spouse Date of Birth Spouse Email Spouse Role Describe the role your spouse intends to take (supportive, co-pastor)? Spouse's Communication Would your spouse like to be included in correspondence from Multiply Vineyard? Yes No Vision* Briefly describe the type of church you envision planting. Location* Where would you potentially plant? Target Plant Date* When would you potentially plant? Sending Pastor's Name* Sending Church Name* Sending Church Location* City and State only Are you being sent by a Vineyard Church?* Yes No Spiritual Life* Describe your relationship with Jesus. Education* List the High School, College and Graduate School you attended. (Include majors, degrees and any courses pertinent to ministry). Job History* List all employment in the past 10 years. Please include company name, position, and why you left employment. Volunteering* How are you currently serving in the local church and community? Leadership Experience* What leadership experience have you had in a church or other setting? Church Planter Training* Are you currently involved in training to be a church planter at your local church (internship, residency program, etc)? If so, please explain. Connection* What Vineyard conferences and trainings have you attended? Vineyard Thought Leadership* What books by Vineyard authors have you read and/or sermons have you listened to that are related to church planting or leadership? Please include title and author. Other Influences* What other books have you read and/or sermons have you listened to that are related to church planting or leadership? Please include title and author. Additional Information* Please share any additional information you would like as part of your application.