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

* 1. Name of Individual being recommened

* 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)?

* 7. Date District Superintendent's Approval was granted

Date

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

Date

* 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.

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

* 11. By vote of  Board on this date:

Date

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

T