This form must be fully completed by the last Friday in October. This form will be sent to your State/Regional Office and a copy will be sent to your email.I am a…MIP CandidateMIP Spouse (Seeking credentials)MIP Spouse (Not seeking credentials)NameEmail Ministerial File#Date MM slash DD slash YYYY Supervising PastorSupervising ChurchDid you have adequate time to complete the assignments? Yes No If not, explain:Did you have weekly meetings with your supervising pastor? Yes No If yes, select the appropriate descriptions of the meetings? Profitable Well-planned Weak Unorganized If not, explain:Did the supervising pastor give you a monthly ministry assignment sheet with assignments? Yes No Did you attend Seminar 1 in October? Yes No How would you rate the seminar? (1-10, with 10 being the highest)What were the strengths about the seminar?What were the weaknesses about the seminar?Describe your relationship with the following people during the month:Supervising Pastor:Members of the church:Church staff:Identify the topics and assignments you completed this month.Teaching TopicsEstablishing community and ministerial relationships Yes No Establishing evangelism methods Yes No Establishing church outreaches Yes No Planting a church Yes No Examples of Coordinating AssignmentsAttend a ministerial association meeting and a denominational ministers meeting, such as a district meeting Yes No Witness to one person Yes No Initiate and maintain an outreach during MIP, such as a convalescent home worship service. Yes No Discuss the experience of planting a church with a church planter. Yes No Other TopicsOther assignmentsName of State/Regional Office(Required)— Select a State/Region —AlabamaAlaskaArizonaArkansasBahamas-Turks IslandCalifornia/NevadaCanada (Ontario)Canada (Quebec/Maritimes)Canada (Western)DelmarvaEast Central Hispanic RegionFlorida (Cocoa)Florida (Tampa)Georgia (North)Georgia (South)Great Lakes RegionGrenadaGulf Rio Grande Hispanic RegionHawaiiHeartlands RegionIllinoisIndianaKentuckyLouisianaMichiganMid-Atlantic Hispanic RegionMidlands RegionMinistry To Military (MTTM)MinnesotaMississippiMissouriNew England (Hispanic)New England (Northern)New England (Southern)New JerseyNew MexicoNew YorkNorth Carolina (Eastern)North Carolina (Western)North Central Hispanic RegionNorth Central RegionNortheastern Hispanic RegionNorthwestern Hispanic RegionOhioPacific Northwest RegionPennsylvaniaRocky Mountain RegionRomanian TerritorySouth CarolinaSouth Central Hispanic RegionSoutheastern Hispanic RegionSouthwestern Hispanic RegionTennesseeTexasVirginiaWest VirginiaConfirm(Required) I have completed this form to the best of my ability. PhoneThis field is for validation purposes and should be left unchanged.