This form is to be completed annually for district licensed ministers.

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* 1. Name of Individual being recommended

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* 6. If the Ministry Role designation of PSV-FT or PSV-PT is recommended for the coming year, has the written approval of the district superintendent been received (Manual 129.27; 159.1-159.2)?

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* 7. If a designation other than "STU" or "U" is indicated above, describe the formal relationship that exists with the candidate, as approved by the church board and the district superintendent.

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* 8. Please certify that the individual name above has fulfilled all the requirements for this recommendation.

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* 9. By vote of  Board on this date:

Date

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* 10. Submitted by Chairperson and/or Secretary; (Please note, the typed names are considered an official signature for this document).

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