Annual Report for Deacons

Annual Report for Deacons
Name

First NameLast Name
Primary Address

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Alternate Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Work Phone
Please enter a valid phone number.Format: (000) 000-0000.
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Address Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email Address (A copy of your submission will be emailed to this address)
example@example.com
Diaconal Status
Please indicate your diaconal status

ActiveSenior
Do you reside in the Archdiocese of Hartford?

YesNo
Do you still regularly serve in a parish?

YesNo
Please indicate your current parish assignment
Do you have faculties in a diocese other than Hartford?

YesNo
If "yes," which diocese(s)?
Out-of-Diocese Deacons Only
Do you return to the Archdiocese during the year?

YesNo
Please check off the months, including parts of months (even if for just a day or two) in which you are typically in the Archdiocese.

JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberNo Fixed schedule
If you minister at a parish when in the Archdiocese, please list the parish(es)
Would you like to change incardination?

YesNo
Spiritual Requirements
Please list below retreats and days of recollection specifically given for deacons only that you have attended in the last year
Spiritual Director type
Spiritual Director name

First NameLast Name
Annual frequency of meetings
Administrative Requirements
Are your funeral arrangements complete, up-to-date and filed with the Diaconate Office?

YesNo
Have you completed twelve hours of continuing education in the last year?

YesNo
Please create or update the list of courses you've taken (Other than Diaconate Office sponsored workshops)
Please list course names, locations and dates
Liturgy and sacraments
Number of times you preach in a year
Number of Baptisms
Number of Marriages
Ministries
Please check the box to the right of each specific ministry in which you are currently active

Baptismal PreparationMarriage PreparationSocial JusticePrisonsAdult EducationRCIAYouth Programs
Other ministries not listed
Do you regularly take time off from your parish duties?

YesNo
Do you attend parish staff meetings?

YesNo
Are you a member of the Parish/Pastoral Council?

YesNo
Do you receive/accept your monthly parish stipend?

YesNo
Please describe your ministry in general terms
Employment and Education
Current or former occupation
Please describe

SecularClerical
Are you retired?

YesNo
Are you planning to retire within the next three years?

YesNo
Do you intend to move out of the Archdiocese within the next three years?

YesNo
Do you have any special needs?
Are you interested in a parish administration position?

Yes, Full-TimeYes, Part-TimeNo
Comments, Questions, Concerns and Recommendations for Diaconate-Sponsored Workshops
Each year the CT Catholic Directory is published, which includes deacon name, address, telephone number, parish assignment and wife's name (if married) unless otherwise specified. Do we have your permission to provide this information for the next publication?

YesNo
Today's Date

MonthDayYear
Date
Should be Empty:

Annual Report for Deacons

Diaconal Status

Out-of-Diocese Deacons Only

Spiritual Requirements

Administrative Requirements

Liturgy and sacraments

Ministries

Employment and Education