CCMA Standing Renewal Report Form

Christian Church (Disciples of Christ) of Mid-America
Standing Renewal
Report Form

Ministers with Standing reserve the privilege to call upon the Christian Church for services, support, References, relocation assistance, Denominational endorsement, and Scholarship aid. In keeping with the design of the Christian Church Disciples of Christ (DOC), each Region annually reviews and certifies the Standing for all Clergy. Ministers with Standing acknowledged by the Mid-America Region will have their name published in the National DOC Yearbook as well as the Mid-America Regional Directory.

This Standing Renewal Report Form allows you to submit an official request for annual renewal as a Commissioned or Ordained Minister with Standing in the Mid-America Region. Please complete all required fields on this form, even if the Regional Office may already have on file some of the information requested. This ensures that your clergy records remain current and accurate.

We appreciate your thoughtful completion of this form. Thank you for all you do in ministry!

Please Note the following:
- Are you an Ordained "Retired-Inactive" Minister? If so, please complete the Retired-Inactive Clergy Information Form, instead of this Standing Renewal Report Form, to update your clergy records.
- Prefer a printed form? You are welcome to request a printed copy be mailed to you with a self-addressed and stamped return envelope by your Ministry Associate in the Springfield Regional Office. Please call (417) 865-0850 or email sgf@ccmadisicples.org.
Reporting Year (to initiate Standing for the current or upcoming year):*

2024 (To initiate Standing for the current year of 2024.)2025 (To initiate Standing for the upcoming year of 2025.)Other
Do you wish to continue your Ministerial Standing with the Christian Church (Disciples of Christ) of Mid-America?*
Title*
Full Name*

PrefixFirst NameMiddle NameLast NameSuffix
Preferred Name*
Email*
Cell Phone Number*
Please enter a valid phone number.
Home Phone Number (if applicable)
Please enter a valid phone number.
Work Phone Number (if applicable)
Please enter a valid phone number.
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Date
Gender
Please use this field at your own discretion.
Ethnicity
Please use this field at your own discretion.
Pronouns
Please use this field at your own discretion.

Ministry Questionnaire: Looking Back

Please reflect on your service in Ministry over the past year as you answer the following questions.
What has given you the most satisfaction and joy?
What has/have been your greatest success(es)? What contributed to your achievement(s)?
What has/have been your biggest challenge(s)? In what ways did/have you overcome said challenge(s)?
Have you taken any theological courses? If so, what courses have you taken and how has this benefited your ministerial growth?
What insights have you gained?
What has influenced your ministry the most?
Are you experiencing any conflict? If so, what is/are the conflict(s) and how have you navigated/been navigating it/them?
How is your emotional, mental, physical, and spiritual health? Are you focusing on self-care? Are your personal and professional needs being met?

Ministry Questionnaire: Looking Ahead

Please reflect on your service in Ministry for the coming year as you answer the following questions.
What is your primary focus for the coming year?
Do you anticipate any major changes in the coming year?
What is your plan for ongoing personal and professional enrichment?
How can your Regional Ministry Team (RMT) best support you and your ministry?

In what year was your last Background Check conducted?*
Date of Last Background Check
1. Have you ever been charged with or convicted of a felony?*

YesNo
2. Have you ever been charged with or convicted of any crime against children or other persons?*

YesNo
3. Is there any other fact or circumstance in your background that should prevent you from being entrusted with the supervision, guidance, and care of children or youth?*

YesNo
Please ensure you have read and understand the following important Regional Documents:
Additional Comments (if applicable)
I hereby submit my Standing Renewal Report Form to the Mid-America Region for the indicated Reporting Year. I have read, understand, and will continue to comply with the Ministerial Code of Ethics, Theological Foundations, and COM 6.

Clear
Thank you for completing your annual Standing Renewal Report Form!

Please also submit your Continuing Education Report Form to ensure that you receive a Standing Card for the current Reporting Year.
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