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The Charles L. Feinberg Center
Preliminary Information Form
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US Minor Outlying Islands
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Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
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Åland Islands
Country
Current Address (If different)
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Date of Birth
*
Phone
*
Email
*
Jewish?
*
Yes
No
Marital Status
*
Single
Married
Widow/Widower
Divorced
Separated
Spouse's Name
*
Is your spouse Jewish?
*
Yes
No
Do you have children?
*
Yes
No
If you have children, please list their names and ages.
*
Are you currently employed?
*
Yes
No
What is your employer's name and address?
*
What is your role/position at the company?
*
Please provide the months/years that you worked at this company (eg. 2004-2011, etc.)
*
What was your previous employer's name and address?
*
What was your role/position at your previous company?
*
Please provide the months/years that you worked at this company (eg. 2004-2011, etc).
*
EDUCATION
Undergraduate Degree
*
School
*
Graduate Degree
Date Format: MM slash DD slash YYYY
School
CHURCH/CONGREGATION INFORMATION
Home Church or Congregation
*
Pastor's Name
*
Church/Congregation Address
*
Are you active in your church/congregation?
*
Current ministry activities outside of church
*
SPIRITUAL INFORMATION
How and when did you come to know Jesus as your personal Messiah?
*
Are you called into ministry? If so, what kind of ministry?
*
Why do you want to serve with Chosen People Ministries?
*
Please tell us with whom and in what capacity do you have the closest relationship to on the CPM staff?
*
Have you participated in a CPM short-term mission or served in a voluntary capacity with CPM?
*
Yes
No
If yes, what did you do and where did you serve?
*
Can you share any experiences you have had in Jewish evangelism?
*
INTERESTS
Please select the following areas of ministry that you are interested in serving in.
*
Short-Term Ministry
Volunteer Ministry
Long-Term Career Assignment
Internship
Charles L. Feinberg Center (Master of Divinity in Messianic Jewish Studies)
Shalom Brooklyn
If you are interested in the MDiv program, is your undergraduate GPA 2.5 or better?
*
Yes
No
If you also have a graduate degree or are currently in graduate school, was/is your GPA 2.5 or better?
Yes
No
If you selected "Long-Term Career Assignment", where are you interested in serving?
*
Are you able to write/speak in languages other than English?
*
Yes
No
Which languages?
*
Levels of proficiency?
1 - Elementary Proficiency
2 - Limited Working Proficiency
3 - Minimum Professional Proficincy
4 - Full Professional Proficiency
5 - Native or Bilingual Proficiency
Have you served in another culture?
*
Yes
No
Please explain the circumstances in which you served in another culture.
MINISTRY GIFTING AND PREFERENCES
Please select the area(s) of ministry that you are particularly gifted in and would prefer to focus on in a possible volunteer or ministry role with CPM.
*
Evanglism
Congregation Planting
Music
Campus Ministry
Discipleship
Children's Ministry
Youth Ministry
Administrative
Other area(s) of ministry not listed.
How did you hear about the Chosen People Ministries?
*
Is there anything else beneficial to know about you?
Please read our Doctrinal Statement, which is found here. A new window will open.
Do you agree with Chosen People Ministries' Doctrinal Statement?
*
Yes
No
If you selected "no", please explain any points of disagreement.
Please feel free to attach any additional documentation such as a biography, resume, or photo that would be helpful for us to consider.
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