CCMA Standing Renewal Report Form

The 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 of Standing as a Commissioned or an Ordained Minister in the Mid-America Region. Even if the Regional Office may already have on file some of the information requested, completion of this Form ensures that your clergy records remain current and accurate.
- If you are an Ordained "Retired-Inactive" Minister, please instead complete the Retired-Inactive Clergy Information Form.
- Should you prefer a printed form be mailed to you with a self-addressed and stamped return envelope, please contact your Ministry Associate in the Springfield Regional Office by phone at (417) 865-0850 or by email at sgf@ccmadisicples.org.
Should you have any questions, please contact your Ministry Associate in the Springfield Regional Office at sgf@ccmadisicples.org. Thank you for all you do in Ministry!
Important Documents for Ministry:
Reporting Year (to initiate Standing for the current or upcoming year):

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
Additional Email (if applicable)
example@example.com
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Phone Number (if applicable)
Please enter a valid phone number.Format: (000) 000-0000.
Work Phone Number (if applicable)
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (if different than physical 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?
2. Have you ever been charged with or convicted of any crime against children or other persons?
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?
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.
Thank you for completing your annual Standing Renewal Report Form!

Please also complete your Professional Development Report Form (formerly referred to as the Continuing Education Report Form) to ensure that you receive a Standing Card for the current Reporting Year.
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