| First Name: |
|
Last Name:
|
| Home Address: |
|
City:
|
Zip:
|
| Office Address: |
|
City:
|
Zip:
|
| Email: |
|
Cell Phone: |
(
)
|
| Office Phone: |
(
)
|
Home Telephone : |
(
)
|
|
Ethnicity:
|
|
| Other - Specify: |
|
| If applicable |
| Spouse's: |
|
Children's Names: |
|
Please check all that apply to you: |
Details:
|
| * If you are fully retired, only sections 3, 4, and 6 are required. However,
please return to the Regional Office so that records are complete |
| |
|
|
| 1. Employment |
|
|
| a. Ministry Related |
|
|
| To what expressions of the Christian Church (Disciples of Christ) are you
accountable for the performance of ministry? |
|
| Name of Position: (pastor, teacher, counselor, etc)
|
| Place of Service:
|
Telephone:(
)
|
| Address:
City:
Zip:
|
|
|
|
| b. If you are not serving in active ministry at the present time, are you in the Search
and Call Process? |
|
| Comments:
|
|
|
|
|
| c. Other Employment |
|
|
| Employer:
|
Telephone: (
)
|
| Address:
|
City:
|
Zip:
|
| |
|
| 2. Education and Experiences |
|
| Name and location |
Degree Received
Year |
| a. College:
|
|
| b. Seminary:
|
|
| c. Other:
|
| d. Qualifications for Standing include participation in "programs of study,
research, growth, and renewal." (Policies, and Criteria for the order of Ministry
[V.B.3.b.]) Please indicate how you have fulfilled this standard during
the past year. |
|
| Describe particular challenges or joys in your ministry that you wish to share: |
|
| |
|
| 3. Ministerial Credentials (Check one) |
|
| a.
Licensed |
|
|
| Congregation:
City:
State:
Expires:
|
|
|
|
|
| b.
Ordained |
|
|
| Congregation:
City:
State:
When:
|
|
|
|
| Regional Participation in Ordination:
|
Name of Region:
|
|
|
|
If ordained in another demonination, please indicate the denomination: |
|
UCC/DOC Partnership Class Attended Date: |
|
| When and where your ordination was recognized by Disciples: |
Date:
|
Region:
|
| |
| 4. Maintenance of Relationship with the Christian Church (Disciples of Christ) |
| “Standing continues so long as the minister maintains relations with the Christian
Church (Disciples of Christ), including participating membership in a recognized
[Disciples)] congregation in the community, where feasible.” (Policies and Criteria
for the Order of Ministry [V.B.3.c.]). |
| a. I am a member of: Church:
City:
|
| b. Participation in the wider Church (Check those that apply in the last year) |
|
| |
|
| List Commission and Committees you currently participate in. |
|
| List Past Commission And Committees you were on. |
|
| |
|
| 5. Affirmations |
|
|
I have read and affirm My Ministerial
Code of Conduct. (Click Here To View) |
|
I have completed a regionally sponsored
workshop on Sexual Ethics |
|
I have completed the Christian Church in Ohio sponsored workshop on Anti-Racism - Pro Reconciliation. |
| |
|
| 6. Signature:
|
Date:
|
| By this submission I indicate my desire to receive Ministerial Standing in the Christian
Church (Disciples of Christ) through the Christian Church (Disciples of Christ)
in Ohio. |
|
|
|
