Confidential Report to the Synodical Bishop

Confidential Report to the Synodical Bishop
Name*

First NameLast Name
Email (used for sending confirmation once submitted)*
example@example.com
Home Phone Number

Area CodePhone Number
Home Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I am a:*

PastorDeacon
My Call is:*

Under Regular CallCall to Special ServiceAppointed InterimOn Leave from CallRetiredDisabledOther
Name of Employer*
Synod*
Congregational Membership
Congregational Membership
Congregational Membership
Congregational Membership
Congregational Membership
What significant events and developments occurred in your faith, ministry and/or life during the past year?
Note any comments, questions, concerns or requests you desire to share with your synodical bishop. Please declare any interest you may have to further participate in the life of your synod or the national church.
Please indicate if you would like a conversation with the bishop.

YesNo, not at this time
Please indicate the purpose for wanting to have a conversation with the bishop.
How do you see God leading you in your ministry in the coming year?
In the past year, did you invite someone to consider ordained ministry and forward their name to the Candidacy or Theological Education and Leadership Committees?

YesNo
Have you exercised your ministry of Word and Sacrament or Word and Service this past year?

YesNoN/A
Did you participate in a continuing education program last year?

YesNoN/A
Number of education days 2020
Reason for education 2020

Skill/Knowledge upgradePersonal InterestCongregational RequestOther
Do you plan to participate in a continuing education program this year?

YesNoN/A
Number of education days 2021
Reason for education 2021

Skill/Knowledge upgradePersonal InterestCongregational RequestOther
How many times did you attend conference or ministerial meetings last year?
What opportunities for cooperative ministry (Lutheran, non-Lutheran, community groups, or other faith groups) have presented themselves to you and your congregation, and what has the experience been like?
Does your congregation have a mutual ministry committee or group with comparable responsibilities?

YesNoN/A
Did you submit the 2018 annual congregational reports (parochial) on members and financial statistics?

YesNoN/A
Please explain why your congregation's parochial report hasn't been submitted.
Are there conversations taking place regarding possible significant changes to the terms of your call?*

YesNoN/A
Please describe these possible changes.

Compensation Information

Please provide the information requested below regarding the salary allowances and benefits received from your congregations(s) in 2020 and to be received in 2021.

	2020	2021
Parsonage provided
Base salary
Housing allowance
Other- utilities
Housing equity
Car allowance
Continuing education
Book allowance
Other

Paid vacation in weeks 2020
Paid vacation in weeks 2021
ELCIC pension member 2020

YesNoN/A
ELCIC pension member 2021

YesNoN/A

Employer contribution to pension plan

	2020	2021
Percentage of salary your employer contribution to ELCIC pension plan
Other Pension

Referencing Synodical Guidelines for the year 2020, you are presently being paid

Below guidelinesAccording to guidelinesAbove guidelines
Other comments
Should be Empty:

Confidential Report to the Synodical Bishop

Compensation Information