East Ohio Conference UMC Leadership Interest Survey

In order to live fully into the mission and vision of the East Ohio Conference, we are developing a "possibilities list" of people who would deepen and broaden their discipleship journey by serving beyond the local church in a conference leadership position. PLEASE NOTE THAT THIS IS NOT A NOMINATION. If you are recommending someone other than yourself to be included in this possibilities list, please do NOT contact that person to see if they will serve. Contacting them may create confusion or a misunderstanding that discourages persons from serving at a later date. The leadership committee will contact people from this list as vacancies to be filled are nominated. 
ALSO NOTE: We ask for gender, race/ethnicity, and age because The UMC Book of Discipline encourages us to have diverse conference leadership. 
Please answer the questions as completely as possible. * indicates a field that requires a response. 
1.Name of person filling out this survey.(Required.)
2.Email of person filling out this survey.(Required.)
All questions following this point refer to the person being recommended. If you are filling this out for yourself, you can skip questions 3 and 4. 
3.Name of person you are recommending (if yourself, leave blank)
4.Email of person you are recommending (if yourself, leave blank)
5.Which best describes your relationship with the UMC?(Required.)
Clergy appointed to local church or extension ministry
Clergy not appointed (retired, leave, etc) 
Lay employee of the UMC
Lay (local church member)
6.Areas of interest, select all that apply:(Required.)
7.Briefly describe specialized training, education, skills, and abilities.  Note any strong interests, hobbies, or other experience.  These help us identify persons who might offer specific expertise needed for corporate boards or in specific areas of ministry.
8.District(Required.)
9.Church and city(Required.)
We ask the following three questions because The UMC Book of Discipline calls for conference leadership to have diversity in age, gender, and race.
10.Gender (we ask this because the Book of Discipline specifies that Boards and Committees should have a mix of male and female members).(Required.)
11.Race or Ethnicity(Required.)
12.Age range (Required.)
Youth in Grades 6-12
Adult Age 18-35
Adult Age 36-50
Adult Age 51-65
Adult Age 66+
13.Please list other local church, district, or conference level leadership positions (if any) currently held.