International Clergy Affiliate Network

I can do all things through Christ Jesus, Who strengthens me. --- Phillipians 4:13

A man will be as a hiding place fom the wind, And a cover from the tempest, As rivers of water in a dry place, As the shadow of a great rock in a weary land.
--- Isaiah 32:2

Revs.. Kathryn van Rooyen, Founder of I CAN and co-director
Rev. David van Rooyen, co-Director


Personal Application for Credentials Online -

I CAN Home - To apply for a Church or Ministry affiliation, contact I CAN

PERSONAL DATA

Personal Application:


E-mail Address (cannot be submitted without it)


Title:

First Name:

Last Name:

Street Address:

City:

State/County:

Zip/Postal Code:

Country:

E-mail:
(Application cannot not be processed without your email.)

Phone:

Mobile:

Fax Number:

Website:

Your mailing address: complete only if different from above address.
This will be where your card and certificate will be sent, if approved.

Mailing Street Address:

City:

State/County:

Zip/Postal Code:

Country:

Sex:: Male Female

Date of Birth:
Day/Mth/Yr

Spouse Date of Birth:
Day/Mth/Yr

Marital Status: Engaged Married Single Divorced Separated

Name of Spouse:

Date of marriage:
Day/Mth/Yr

Is your spouse or fiancee saved:
Yes No

Is your spouse or fiancee in support of your call to ministry: Yes No

CHURCH AFFILIATION AND REFERENCES

Name of the church which you currently pastor or attend:

Senior Pastor's Name:

Street Address:

City:

State/Prov:

Zip/Postal Code:

E-mail:

Phone:

FIRST PERSONAL/MINISTRY CHARACTER REFERENCES

(Please identify someone other than a family member whom you have known for more than a year.)

Name:

Street Address:

City:

State/Prov:

Zip/Postal Code:

E-mail:

Phone:

SECOND PERSONAL/MINISTRY CHARACTER REFERENCE

(Please identify someone other than a family member whom you have known for more than a year.)

Name:

Street Address:

City:

State/Prov:

Zip/Postal Code:

Country:

E-mail:

Phone:

YOUR MINISTRY

Do you have a call of God on your life to enter the ministry full-time: Yes No

Type of Ministry (Teacher, Counselor, Prophet, Pastor, Hospital worker, Evangelist, etc.)

If yes, please explain your vision for ministry:

Are you presently or have you ever been licensed or ordained: Yes No

If so, please list the denomination/organization and date of credentials:

(Please attach a copy of credentials.)

Identify the area(s) of ministry, according to Ephesians 4:11.
Apostle Prophet Evangelist Pastor Teacher Helps

Do you agree with the I CAN Revealed Heart Ministries' Statement of Faith: Yes No
(If you disagree with any point, please explain.

Why do you want to join I CAN and how can I CAN help you in your ministry?
Explain:

How did you hear about I CAN?
Describe briefly

YOUR SPIRITUAL PILGRIMAGE

Date when you were born again:

EDUCATIONAL HISTORY

List all Bible School / College you have attended:

List all higher educational institutions attended and degree earned:

STATEMENT OF TRUTH

I understand all items submitted to I CAN as part of the application process become the property of I CAN and will not necessarily be returned.

This application will be held in confidence. Only those persons with a need to know will review it. I grant I CAN permission to review the information provided on this form.

I hereby state that all the information contained on this application is correct and true. If I CAN is notified that any of the information contained on this application is false, it will be grounds for immediate cancellation of application procedure and/or revocation.

Date Submitted
Day/Mth/Yr

PAYMENT
Application cannot not be processed without payment.
After you submit this form a payment option page will be presented.

PayPal Money Order Check

l am applying for: Amount: USA $
Christian Helper: $25 Licensed: $75 Ordained: $120


Be sure to review your application before sending
Once you submit this page, you will get a page saying it has been submitted, and it will give you the information you have listed. Due to a technical difficulty, this information does NOT actually get sent to us. PLEASE copy the page you see, and email it to us at ican@revealedheartministries.org. Again, it will say you submitted it, but it doesn't actually reach us. THANK YOU.