Application for Ministry Licensing  
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I hereby apply to the Bishop of Western New York to be licensed in the following ministry or ministries of this diocese: *
License Requested:
Required
I certify that the following person has fulfilled the requirements for licensing and that I will continue to grow in their understanding of God’s Word and the faith and tradition of our Church as well as the practical aspects of the ministries in which I serve God and God’s people through my congregation.
Applicant's Name *
Parish *
Diocese *
E-Mail Address *
I hereby recommend that the person listed above be licensed as specified.  I hereby certify that the requirements for this license have been met.
Priest's Endorsement
Priest's Name *
Date
MM
/
DD
/
YYYY
Vestry/Council Endorsement
Clerk of Vestry/Council Member
Date
MM
/
DD
/
YYYY
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