2024 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 *

Question Title

* 2. I Currently hold standing in the

Pennsylvania Region

West Virginia Region

Other (please specify)

Question Title

* 3. Preferred Method of Contact

Cell Phone Voice

Cell Phone Text

Snail Mail

Question Title

* 4. I am a/an:

Ordained Minister

Commissioned Minister

Retired Ordained

Retired Commissioned

Please list the Date and Body of Commissioning/Ordination

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

Question Title

* 6. This is a:

Full time position

Part-time position

Retired

Question Title

* 7. Congregation in which your membership is maintained:

Congregation Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone Number

Question Title

* 8. Describe your involvement in ministry in Your local Church during the past year:

Question Title

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

Question Title

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

Question Title

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

Question Title

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

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)

Question Title

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

Yes

Question Title

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

Yes

Question Title

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

Question Title

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

Yes

If yes, please elaborate:

Question Title

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

Yes

IF yes, please elaborate:

Question Title

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

Yes

If yes, please elaborate:

Question Title

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

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?