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FREE Eligibility Evaluation

Find out FREE if you are eligible to become certified or licensed with UACCCI by filling out the form below and submitting it to UACCCI.

INSTRUCTIONS

Please answer all questions below and submit. This form will get the process started with your evaluation and you will receive an Email or a phone call usually within 24-48 hours Monday – Friday (excluding holidays).

DO NOT use quote marks("). It will cause your answers to be cut off.

Name:

Address:

Daytime Phone:

Evening Phone:

Cell Phone:

Date of Birth:

Are you applying to become ordained?:

YesNo

Title for your ordination:

N/AReverendMinisterChaplainCounselor

Name of church where you are a member:

Full Address of Church:

Pastor’s name (if you are not the pastor):

Church Phone Number:

Church E-Mail Address:

Web site of your church or ministry:

Does your family support your ministry decisions?

Tell us about your church and your ministry or leadership position:

Describe your doctrinal position. What changes (if any) have you made in your doctrine as a result of your studies and growth?

List and describe your educational and ministry experiences. What degrees do you have and from where?

Is there anything else special that we should know about you?

Your Name:
Email Address:

Once you are satisfied with your answers,
please SUBMIT your application to us.

Please wait for the confirmation page to show
you that we have received your results...