This form is to be filled out Annually for District Licensed Ministers, Deaconess' License, Director of Christian Education License, or other ministerial communions.
Name of Individual being recommened

Question Title

* 1. Name of Individual being recommened

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; 160,1-160.2)?

Question Title

* 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; 160,1-160.2)?

Date District Superintendent's Approval was granted

Question Title

* 7. Date District Superintendent's Approval was granted

Date
If approval has not yet been received, date which written approval was sent to the District Superintendent.

Question Title

* 8. If approval has not yet been received, date which written approval was sent to the District Superintendent.

Date
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.

Question Title

* 9. 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.

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

Question Title

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

By vote of  Board on this date:

Question Title

* 11. By vote of  Board on this date:

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

Question Title

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

T