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* 1. Please enter your current contact information

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* 2. I Currently hold standing in the

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* 3. Preferred Method of Contact

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* 4. I am a/an:

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* 5. Please enter your current ministry setting information.  If you are retired, you may skip this question. 

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* 6. This is a:

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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:

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* 9. Describe your involvement in ministry in the Regional church during the past year:

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* 10. Describe your involvement in ministry in the General church during the past year:

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* 11. Describe your involvement in ministry in the Ecumenical  church during the past year:

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

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* 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:

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

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* 15. Have you reviewed and agree to adhere to the “Ministerial Code ofEthics”?

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

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

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* 19. Is there any reason that you shouldnot be entrusted with the care, guidance or supervision of children or youth?

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

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* 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?

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