Oblate Application

Christ Mission Anglican Benedictines

3589 Bent Trace Drive
High Point, North Carolina 27265

Personal Contact Information

Name

Date of Birth

Phone Number

Street Address or P.O. Box Number

City

State

Zip Code

Country

Emergency Contact

Phone Number

Street Address or P.O. Box Number

City

State

Zip Code

Phone Number

Denominational Affiliation

Ordained

Yes No

Name of Parish or Congregation

Street Address

City

State

Zip Code

Name of Priest or Senior Pastor

Contact Information

Date that I was baptized

Date I was confirmed into the Church

I am active in my local parish/congregation.

Yes No

I am striving to live as a disciple of Christ.

Yes No

Recommendation #1 - Priest or Senior Pastor (Bishop or Regional Supervisor if Ordained)

Phone

Street Address

City

State

Zip Code

Recommendation #2

Phone

Street Address

City

State

Zip Code

Recommendation #3

Phone

Street Address

City

State

Zip Code

Personal Biography

Certicification of Accuracy

I certify that my answers are true and complete to the best of my knowledge. If this application leads to acceptance into the community, I understand that false or misleading information in my application or interview may result in my dismissal from Christ Mission Anglican Benedictines.

Name

Date of Certification

1696