Transfer Credential Form

Name *

First

Last

Credential Level *

Previous Address *

Current Address *

District I will be transferring to: *

Date planning to leave the Rocky Mountain District *

Email *

My new ministry will be: *

Place of Birth *

Date of Birth *

Social Security Number *

Spouse Name

First

Last

Spouse Place of Birth

Spouse Date of Birth

Ministry Activity

Child Name / Date of Birth

Year Credentialed by the Assemblies of God:

District you were Credentialed in:

Credentials from other organizations:

Years Credentialed:

Pastorates / Other Ministries (Type, Places, and Dates):

Additional Information:

Phone

Serving pastors, churches, and ministries across Colorado and Utah through leadership, resourcing, and missional partnership.

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