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Application for the student to be completed by the pastor.

Please note the $25 fee is non-refundable.

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* 1. Student's First and Last Name

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* 2. Student's Cell Phone

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* 3. Student's Email Address

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* 4. Student's Mailing Address

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* 5. Student's Gender

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* 6. Student's Date of Birth

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* 7. Church Affiliation

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* 8. Do you intend to pursue the Lay Minister Certificate?

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* 9. Are you a member of the Church of the Nazarene?

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* 10. Have you received approval from your local pastor?

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* 11. Pastor's Full Name

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* 12. Pastor's Cell Phone

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* 13. Pastor's Email Address

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