2023 WV & PA Ministerial Standing Form Question Title * 1. Please enter your current contact information First Name * Last Name Home Address * Home Address 2 City/Town * State/Province * ZIP/Postal Code * Email Address * Phone Number * OK Question Title * 2. I Currently hold standing in the Pennsylvania Region West Virginia Region Other (please specify) OK Question Title * 3. Preferred Method of Contact Email Cell Phone Voice Cell Phone Text Snail Mail OK Question Title * 4. I am a/an: Ordained Minister Commissioned Minister Retired Ordained Retired Commissioned Please list the Date and Body of Commissioning/Ordination OK Question Title * 5. Please enter your current ministry setting information. If you are retired, you may skip this question. Ministry Setting Ministry Address Ministry Address 2 City/Town State/Province ZIP/Postal Code Website address Phone Number OK Question Title * 6. This is a: Full time position Part-time position Retired OK Question Title * 7. Congregation in which your membership is maintained: Congregation Name Address Address 2 City/Town State/Province ZIP/Postal Code Phone Number OK Question Title * 8. Describe your involvement in ministry in Your local Church during the past year: OK Question Title * 9. Describe your involvement in ministry in the Regional church during the past year: OK Question Title * 10. Describe your involvement in ministry in the General church during the past year: OK Question Title * 11. Describe your involvement in ministry in the Ecumenical church during the past year: OK Question Title * 12. Have you financially contributed to a Disciples of Christ Congregation or DMF in 2022? OK Question Title * 13. The practice of ministry involves participation in study, growth and renewal. Indicate experiences by which you have endeavored to strengthen your ministry in these ways during the past 12 months: Regional trainings Ecumenical trainings Tuesday Clergy Calls Regional Assembly General Assembly Camp/Conference Staff Ecumenical Organization Leadership Boundary Training Anti-Racism Training Other (please specify) OK Question Title * 14. Are you willing to be a faithful minister serving within and supportive of the Christian Church (Disciples of Christ)? Yes No OK Question Title * 15. Have you reviewed and agree to adhere to the “Ministerial Code ofEthics”? Yes No OK Question Title * 16. I have reviewed the Areas of Ministerial Practice and have concentrated my efforts of self-improvement in the past year on: OK Question Title * 17. Have you ever been charged with or convicted of a felony? Yes No If yes, please elaborate: OK Question Title * 18. Have you ever been charged with or convicted of any crime against persons? Yes No IF yes, please elaborate: OK Question Title * 19. Is there any reason that you shouldnot be entrusted with the care, guidance or supervision of children or youth? Yes No If yes, please elaborate: OK Question Title * 20. Have you encouraged anyone to consider ministry as a vocation recently? What is their name and contact information? OK Question Title * 21. Are there any ways the Regional Commission on Ministry or the Regional Minister and staff can be of assistance to you at this phase in your ministry? OK DONE