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COVENANT PARTNERSHIP APPLICATION
For Local Churches, Para church Ministries, Marketplace Ministries, and
Networks
Church/Ministry Affiliation with Hakeem Collins Ministries/Champions International is based upon
the mutual desire to develop relationships in an apostolic network of churches/ministries for the
purpose of New Testament ministry including: fellowship, ministry equipping, church planting, and
evangelism and missions outreach. CNI provides covering, counsel, and spiritual accountability, but
is not connected legally or involved in the governing of local churches/ministries, other than to be
available upon request to set a church/ministry in order, and speak into it according New
Testament five-‐fold ministry and relational structure.
APPLICATION REQUIREMEMENTS
1. Church/Ministry Vision - Enclose a copy of the vision and any promotional material..
2. Recommending Pastor - If you are already credentialed, omit this requirement.
Pastor: Telephone:
Address:
City, State & Zip:
3. $100 Application Fee -‐ Includes Annual Fee for the first calendar year of affiliation.
Make check payable to Champions International Ministries or Hakeem Collins
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Church/Ministry Name:
Street Address:
City, State, Zip:
Telephone: Fax:
Avg. Attendance: Web Page: E-‐mail:
Senior Pastor/Ministry Leader:
Address:
City, State, Zip
Telephone: E-‐mail:
___________________________________________________________________________
___________________________________________________________________________
Senior Pastor’s/Ministry Leader’s Signature Date
Return application with enclosures to:
Champions International Ministries, P.O BOX 305 Wilmington, DE -‐ (267) 798-‐6389
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APPLICATION REQUIREMENTS
1. A DEFINITE CALL TO MINISTRY
* Certificate of Ministry – Call to Serve Under a Pastor in Local Church Ministry
* License Or Ordination – Call to the Five-‐fold Ministries, or other Ministries
* Membership – Only for Ministers Licensed or Ordained in a Denomination which does not
permit them to be credentialed with HCM (Include a copy of the current credential with the
application.)
* Church or Ministry Affil iation – Churches/Ministries called together for covering,
fellowship, and kingdom ministry purposes.
2. ACTIVE SERVICE IN MINISTRY PROPORTIONAL TO THE CREDENTIAL
Level of Ministry Position/Experience Will in part Determine the Level of Credential
3. APPLICATION FORM COMPLETED AND RETURNED
4. $75 APPLICATION FEE
Includes the annual $50 credential fee for the first year (the fee is refundable in the unlikely event
of denial).
5. TWO RECOMMENDATIONS ON THE ENCLOSED FORMS:
(1) Your current local church pastor or ministry you are serving.
(2) A person who has known you well for at least 3 years (a Minister, friend, employer, etc.).
Important: Can Not Be A family Member.
IMPORTANT NOTE: Recommendations must be turned in to HCM directly by person completing the
form.
6. COMMITMENT TO WALK IN AGREEMENT
Signed commitment on the Application to walk in agreement with the HCM
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Leadership, Statement of Faith, Biblical standards for personal life and ministry.
APPLICATION FORM
1. Attach a CURRENT PHOTO (head and shoulders only). If you and your spouse are both applying, two
separate applications must be completed.
2. Please attach membership fee payment to this form. Application will not be processed without payment.
* REQUIRED *
ATTACH A RECENT TO APPLICATION
HEAD AND SHOULDERS
Please check method of payment -‐ Money Order or Check should be payable to
CHAMPIONS INTERNATIONAL:
MasterCard Visa Money Order Check # ____________________
Card Number ____________ ____________ ____________ ____________
Amount $______________________ Exp. Date: _________/_________
Signature: ______________________________________________________
3. PLEASE TYPE or PRINT CLEARLY. If a question does not apply, type or print DNA.
4. I am applying for (please check one): Ministry Certificate License Ordination
Membership
PERSONAL INFORMATION Please print or type information.
Mr./Mrs./Ms.__________________________________________________________________________
Name (last) (first) (middle) (maiden)
_____________________________________________________________________________________________ Apt.
____________________
Present
Address_________________________________________________________________________________________________
__________________________________________________________________________________
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City State Zip
Phone: (_______) ________- ________Website:_____________________________________________________
Other - List: (_______) __________-___________ E-mail Address:
_________________________________________________________
US Citizen: Yes No If no, Country of Citizenship: _______________________ If permanent resident alien, please
enclose copy of green card.
Sex: Male Female Date of Birth: _______/_______/_______ Age: __________
Spouse: Date of Birth: _______/_______/_______ Age: __________
Marital Status: Engaged* Married Single Divorced** Separated**
* If you are currently engaged, please send us written confirmation once you are married so we can update our
records.
** If divorce or separation has occurred in the past 3 years, please attach complete details typed on separate
sheet.
Name of Spouse or Fiancé (e):
____________________________________________________________________________________
P.O BOX 305, WILMINGTON DE 19899
Phone: (267) 798-‐6389
Email: [email protected] www.hakeemcollinsministries.com Date of marriage, present or proposed:
____________________________________________________________________________________
Is your spouse or fiancé (e) saved? Yes No
Is your spouse or fiancé (e) filled with the Holy Spirit with the evidence of speaking in tongues? Yes No
Is your spouse or fiancé (e) in full support of your call to ministry? Yes No
If not, explain why?
________________________________________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________________________________________
__________________________________________________________________________________
EDUCATIONAL HISTORY
Circle highest level attained: 1 2 3 4 5 6 7 8 9 10 11 12 GED Vocational/Technical: 1 2
College: 1 2 3 4 Bible School Associate Bachelor Master’s Specialist Doctorate
List all higher educational institutions attended and degree earned:
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Name of School Dates Major Diploma/Degree
________________________________________________________________________________________________________
__________________________________________________________________________________
CHURCH AFFILIATION AND REFERENCES Print or type the name of the church which you currently pastor or are a member of. If you are a member of CIM, your
member number is
_____________________________________________________________________________________________
(________)____________________________________________________________________________________
Name of Church Phone
________________________________________________________________________________________________________
____________________________________________________________
Street
Address_________________________________________________________________________________________________
____________________________________________________________
City State Zip
________________________________________________________________________________________________________
____________________________________________________________
Senior Pastor Denomination/Organization
Web Site of above Church: _______________________________________________ E-mail address:
_________________________________________________________________________________
How long have you attended this church? _______________ If less than one year, list the name of the church you
formerly attended, including address, phone number and senior pastor’s name. Also, list how long you attended and
reason for leaving:
________________________________________________________________________________________________________
__________________________________________________________________________________
________________________________________________________________________________________________________
__________________________________________________________________________________
Name: ________________________________________________
PERSONAL / MINISTRY CHARACTER REFERENCES Please identify two references other than family members who have known you for more than a year.
____________________________________________________________________________________
Name Street Address Apt.
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____________________________________________________________________(______) ________________
City State Zip Phone
____________________________________________________________________________________
Name Street Address Apt.
____________________________________________________________________(_______) ________________
City State Zip Phone
YOUR SPIRITUAL PILGRIMAGE
Date you were saved: ______/______/______ Were you raised in a Christian home? Yes No
Denomination/Organization:
_______________________________________________________________________________________
BRIEFLY relate your conversion experience:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
________________________________________________________________________________________________________
____________
Date you were baptized by immersion: ______/______/______
Date you were baptized with the Holy Spirit with the evidence of speaking in tongues: ______/______/______
Understanding that a minister of the Gospel must maintain the highest moral and ethical standards; do you
feel there is any area of your personal life that would hinder your ministry at this time? Yes No
If yes, please explain:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
_________________________________________________
Do you currently use tobacco, alcohol or illegal drugs? Yes No If so, please explain on a separate
sheet.
Are you familiar with the ministry of Hakeem Collins Ministries, Inc.? Yes No
Have you read any of his material, books, listened to his tapes, or watched any of his video or follow him on
social media? Yes No
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YOUR VISION
In an effort to understand your vision concerning your ministry, please attach a one-page, typed essay.
YOUR MINISTRY
Do you have a definite call of God on your life to enter the full-time ministry? Yes No
If yes, please explain on a separate sheet.
In an effort to understand your current involvement in ministry, please attach a one-page typed essay of
explanation.
Are you presently or have you ever been licensed or ordained? Yes No
If so, please list the level and denomination/organization and date of credential; and, please attach a
copy:_______________________________________________________________________________
If you are going to leave or have left the denomination/organization where credentialed, please explain
why:_________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_______________________________________
Identify the area(s) of the five-fold ministry, according to Ephesians 4:11, in which you are called by God:
Apostle____Prophet____Evangelist____Pastor_____Teacher
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_______________________________________
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YOUR INTEREST IN HAKEEM COLLINS MINISTRIES
Do you agree with the Hakeem Collins Ministries (HCM) Statement of Faith? Yes No If you disagree
with any point, please explain on a separate sheet of paper.
Why do you want to join HCM and how can HCM help you in your ministry?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_________________________________________________________
How did you hear about Prophet Hakeem Collins?
_____________________________________________________________________________________________
___________________________________________________________________________
Have you previously submitted an application to HCM? Yes No If so,
when:________________________________________________________________________________________
___________________________________________________________________________
STATEMENT OF TRUTH
I understand all items submitted to HCM as part of this application process become the permanent
property of HCM and will not be returned.
This application will be held in confidence. Only those persons with a need to know will review it. I
hereby grant HCM and its leadership permission to verify the information provided on this
application including references, recommendations and back ground checks. I hereby state that all
the information contained on this application is correct and true. If HCM is notified that any of the
information contained on this application is false; it will be grounds for immediate cancellation of
application procedure and/or revocation.
__________________________________________________________________________________
Signature of Agreement Date
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HCM MINISTER’S COVENANT
Upon acceptance of ministerial credentials from Hakeem Collins Ministries (HCM), I hereby agree
to covenant based on the following: To uphold the biblical standards of holiness and Godly conduct
that are set forth in the Word of God governing ministers, in my personal life as well as my
professional life; To submit to the leadership and covering provided by HCM, and to receive the
wisdom, counsel and restoration available through HCM leadership; To commit to the HCM
Statement of Faith and to faithfully minister sound doctrine; To support HCM with my prayers,
financial support with tithes and offerings and with my presence at all meetings and functions
provided by the fellowship whenever possible; To maintain a level of excellence and quality of
ministry that will enhance and be an asset to Hakeem Collins Ministries; and
I prayerfully and willfully submit this application this the _______ day of __________________,
20______.
_____________________________________________________________________________________
___________________________________________________________________
Signed:
Name: _____________________________________________________________