2024 Northeastern Ministerial Standing Form Survey

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* 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 *

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* 2. Preferred method of contact:

Voice Cell Phone

Text Cell Phone

Snail Mail

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* 3. I am a/an:

Ordained Minister

Commissioned Minister

Retired Minister

Please list the Date and Body of Commissioning/Ordination. If retired, please list the date of retirement.

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* 4. Please enter your current ministry setting information: If retired, you may skip to question 6.

Ministry Setting

Ministry Address

Ministry Address 2

City/Town

State/Province

ZIP/Postal Code

Website address

Phone Number

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* 5. This is a:

Full time position

Part-time position

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* 6. Which geographical area of the Northeastern Region is your ministry setting located in? If you are retired, what geographical area do you currently reside in?

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* 7. Congregation in which your membership is maintained:

Congregation Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone Number

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* 8. Describe your involvement in ministry in your local church during the past year: (If none, please write none)

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* 9. Describe your involvement in ministry in the Regional church during the past year:(If none, please write none)

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* 10. Describe your involvement in ministry in the General church during the past year: (If none, please write none)

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* 11. Describe your involvement in ministry in the Ecumenical church during the past year: (If none, please write none)

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* 12. Describe your involvement in teaching ministry in higher education, various forms of chaplaincies, pastoral counseling, or other activities that are recognized as ministry by the Christian Church (Disciples of Christ) . (If none, please write none)

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* 13. Have you financially contributed to a Disciples of Christ Congregation or DMF in 2023?

Yes

Other (please specify)

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* 14. 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 5 Years:

Seminary training/Certificate Program

Continuing Eduration/ Seminary Events

Ecumenical/interfaith trainings

Regional Assembly

General Assembly

Camp/Conference Staff/Youth Events

Ecumenical/Interfaith Organization Leadership

Boundary Training

Anti-Racism Training

Clinical Pastoral Education (CPE)

Review of Disciples History and Polity

N/A

Other (please specify)

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* 15. If you check marked above that you have attended trainings, please list the date of attendance, organization/person that provided it and place it occurred.

Training 1:

Training 2:

Training 3:

Training 4:

Training 5:

Training 6:

Training 7:

Training 8:

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* 16. Are you willing to be a faithful minister serving within and supportive of the Christian Church (Disciples of Christ)?

Yes

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* 17. Have you reviewed and agree to adhere to the “Ministerial Code of Ethics”?

Yes

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* 18. I have reviewed the Areas of Ministerial Practice and have concentrated my efforts of self-improvement in the past year on:

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* 19. Have you ever been charged with or convicted of a felony?

Yes

If yes, please elaborate:

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* 20. Have you ever been charged with or convicted of any crime against persons?

Yes

IF yes, please elaborate:

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* 21. Is there any reason that you should not be entrusted with the care, guidance or supervision of children or youth?

Yes

If yes, please elaborate:

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* 22. 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?

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* 1. Please enter your current contact information

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* 2. Preferred method of contact:

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* 3. I am a/an:

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* 4. Please enter your current ministry setting information: If retired, you may skip to question 6.

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* 5. This is a:

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* 6. Which geographical area of the Northeastern Region is your ministry setting located in? If you are retired, what geographical area do you currently reside in?

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* 7. Congregation in which your membership is maintained:

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* 8. Describe your involvement in ministry in your local church during the past year: (If none, please write none)

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* 9. Describe your involvement in ministry in the Regional church during the past year:(If none, please write none)

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* 10. Describe your involvement in ministry in the General church during the past year: (If none, please write none)

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* 11. Describe your involvement in ministry in the Ecumenical church during the past year: (If none, please write none)

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* 12. Describe your involvement in teaching ministry in higher education, various forms of chaplaincies, pastoral counseling, or other activities that are recognized as ministry by the Christian Church (Disciples of Christ) . (If none, please write none)

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* 13. Have you financially contributed to a Disciples of Christ Congregation or DMF in 2023?

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* 14. 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 5 Years:

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* 15. If you check marked above that you have attended trainings, please list the date of attendance, organization/person that provided it and place it occurred.

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* 16. Are you willing to be a faithful minister serving within and supportive of the Christian Church (Disciples of Christ)?

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* 17. Have you reviewed and agree to adhere to the “Ministerial Code of Ethics”?

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* 18. I have reviewed the Areas of Ministerial Practice and have concentrated my efforts of self-improvement in the past year on:

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* 19. Have you ever been charged with or convicted of a felony?

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* 20. Have you ever been charged with or convicted of any crime against persons?

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* 21. Is there any reason that you should not be entrusted with the care, guidance or supervision of children or youth?

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* 22. 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?

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* 23. Have you encouraged anyone to consider ministry as a vocation recently? What is their name and contact information?

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* 24. This is a space for you to add any comments for further explanation or clarification on questions that you needed to expound on.