*1.Address(Required.)

Congregation

City/Town

ZIP/Postal Code

*2.Call terms(Required.)

Full-time

Part-time

3.If part-time what percent of a 40 hour week? Ex. 30 hours per week would be 30/40 or 75%. (enter has a percentage)

*4.Salary, enter as a numerical value. (do NOT include housing, social security or other compensation)(Required.)

5.Housing allowance, enter as a numerical value. (if you live in a parsonage leave blank)

6.Housing equity, enter a numerical value (enter an amount if you live in a parsonage)

*7.Enter 1/2 of your Social Security (enter a numerical value)(Required.)

*8.Medical Coverage (select only one)(Required.)

Rostered leader only

Rostered Leader & Spouse

Rostered Leader & Spouse & Child(ren)

Rostered Leader & Child(ren)

Coverage waived

*9.Medical coverage cost (numerical value)(Required.)

*10.Vacation time (in weeks) (numerical value)(Required.)

*11.Number of Sundays off for vacation only (numerical value)(Required.)