Mid-Year Appointment Form/Change in Status Form 2023-2024
This form is to be completed by District Superintendents/District Admins any time there is a clergy status change including a new appointment or change in an existing appointment:
District Superintendent Filling Out Form and District
*
Coastal Virginia: Rev. Dr. Cecelia Brooks
Living Waters: Rev. Jay Carey
Mission Rivers: Rev. Dr. Charles Ledlum-Bates
Mountain View: Rev. Denise Bates
Northern Virginia: Rev. Dr. Sarah Calvert
Shenandoah River: Rev. Dr. Victor Gomez
Three Notch'd: Rev. Dr. Hyo Lee
Valley Ridge: Rev. Doug Forrester
D.S. Email/District Admin Email - a copy of this form will go to the email address in the box below:
*
example@example.com
Name of Person Leaving Appointment or Changing Status
*
Prefix
First Name
Last Name
Suffix
Name of Spouse (if applicable)
First Name
Last Name
Preferred Mailing Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Cell Phone Number
*
Please enter a valid phone number.
Home Phone Number
Please enter a valid phone number.
Office Phone Number
Please enter a valid phone number.
Reason for changing appointment or status
*
1st time appointment in VAUMC
Changing appointment mid-year
Going on personal, transitional, family or medical leave
Leaving current appointment to go to a new appointment
Early retirement
Discontinued
Terminated
Withdrawal by turning in credentials
Withdrawal to Unite with Another Denomination
Other
Choose one:
*
This person's conference relationship status will not be changing (skip previous conference relationship question below).
This person's conference relationship will be changing, complete previous conference relationship and new conference relationship status questions below).
Previous Conference Relationship (if applicable):
Please Select
AF Affiliate Member
AM Associate Member
EP Minister Recog. from other Denom.
CLM Certified Lay Minister
FD Deacon in Full Connection
FL Full-time Local Pastor
LM Certified Lay Minister
MOD Minister, Other Denom., Serving Ecumenical Parish
OA Associate Member, Other Annual Conf.
OD Deacon Member, Other Conf.
OE Other Methodist
OF Full Member, Other Denom
OP Provisional Member, On Loan
OR Retired FE, Other Conference
PD Provisional Deacon
PE Provisional Elder
PL Part-time Local Pastor
RA Retired Associate Member
RD Retired Deacon
RE Retired Elder
RL Retired Local Pastor
ROF Retired, Other Denom.
ROM Retired, Other Methodist
SP Student Local Pastor
SY Lay Supply
Other
If other, please specify:
Previous Appointment (if applicable)- This includes leave, retirement, MQ20 etc.
Is this a new person or someone who has already been serving in the VAUMC.
*
New person.
Has previously served in the VAUMC.
If this is a new person please share if they are coming to serve from another conference.
New Conference Relationship (if applicable):
Please Select
AF Affiliate Member
AM Associate Member
CLM Certified Lay Minister
EP Minister Recog. from other Denom.
FD Deacon in Full Connection
FL Full-time Local Pastor
LM Certified Lay Minister
MOD Minister, Other Denom., Serving Ecumenical Parish
OA Associate Member, Other Annual Conf.
OD Deacon Member, Other Conf.
OE Other Methodist
OF Full Member, Other Denom
OP Provisional Member, On Loan
OR Retired FE, Other Conference
PD Provisional Deacon
PE Provisional Elder
PL Part-time Local Pastor
RA Retired Associate Member
RD Retired Deacon
RE Retired Elder
RL Retired Local Pastor
ROF Retired, Other Denom.
ROM Retired, Other Methodist
SP Student Local Pastor
SY Lay Supply
Withdrew Credentials
Withdrew to Unite with Another Denomination
New Appointment Position Title (if applicable)
Appointment Information
Name of Appointment (if applicable)
GCFA Number of New Appointment (if applicable)
What is this person's salary for this new appointment/change in status? (if applicable)
Percentage Appointed
25%
50%
75%
100%
N/A or Other
If you chose other please specify below:
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If going on leave, please specify what type of leave:
Please Select
Personal
Family
Transitional
Medical
Will the clergy person be living in a parsonage in the new appointment? (if applicable)
Yes.
No.
If the clergy person will not be living in a parsonage will they be receiving a housing allowance? If so, what is the amount?
Is the person's new appointment/change of status in the same District as their previous appointment/status? (if applicable)
Same District
New District
Transferring to another conference
Other
Specify if you chose the option transferring to another conference or other above.
If the person will be moving to a new District which is different than their previous appointment/status choose the District below (if applicable)
Coastal Virginia
Living Waters
Mission Rivers
Mountain View
Northern Virginia
Shenandoah River
Three Notch'd
Valley Ridge
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What is the effective date this new status or appointment will begin?
*
-
Month
-
Day
Year
Date
Important Info: Please share any other important info for the Cabinet, Pensions Office, Communications Office, and the Office of Clergy Excellence:
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