Request to Add/Retain Associate Staff in the Local Church
By completing this form, you confirm that you have read and agreed to the stipulations listed in the Staff Approval Letter regarding: V. Associates in the Local Church (Church of the Nazarene Manual: paragraph 139.27, 2023)
Associate's Name
*
First Name
Last Name
Associate's email address:
example@example.com
Associate's mailing address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Church Name:
*
Area of Ministry:
*
Spouse's name (if married):
First Name
Last Name
1. Has this person enrolled in the Course of Study for ministers?
*
Yes
No
N/A
2. Has this person completed at least two Course of Study classes in the past year?
*
Yes
No
N/A
3. A resume of this associate/staff has been submitted to the District Superintendent (required):
*
Yes
No
If a resume has not been submitted, please upload here or email it to sacdist@sacnaz.org:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
4. At least two favorable written references are on file at the local church on behalf of this person:
*
Yes
No
5a. Requesting permission to: (choose one)
*
Add (new hire)
Retain
5b. List the effective date of new hire or retain:
*
-
Month
-
Day
Year
Date
6. This person has been cleared to serve in the local church by the following means: (check all that apply)
*
Global Ministry Center Verification of Credential History Clearance
Department of Justice background check
Ministry Safe training certificate
There is no backgound clearance on file for this person
Other
7. This person is serving: (choose one)
*
Full time (at least 30 hours/week)
Part time (anything less than 30 hours/week)
8. This person is: (choose one)
*
Paid
Unpaid
9. From this ministry position, this person derives: (choose one)
*
At least 51% of their income
Less than 51% of their income
Not paid
10. Compensation detail (if applicable) - TOTAL ANNUAL compensation plus benefits:
*
Enter 0 if unpaid
11. This person is: (choose one)
*
Not Credentialed
Local Licensed
District Licensed
Ordained
12. If this person is Ordained or District Licensed, please provide their social security number (used for confidential Pensions & Benefits reference only):
*
Enter N/A if Not Credentialed or Local Licensed
13. All Shares for Others will be paid in full by the end of the current Church/Fiscal Year (March 1 - February 28 or 29):
*
Yes
No
14. We have read and are in compliance with the above Manual statement 139:
*
Yes
No
15. We affirm that by Church Board action, this individual has been approved to be retained or hired:
Name of Church Board Secretary
*
First Name
Last Name
Name of Senior/Lead Pastor
*
First Name
Last Name
Date of church board action:
*
-
Month
-
Day
Year
Date
16. I certify that the above statements are true.
Name of person submitting this form:
*
First Name
Last Name
Title of person submitting this form:
*
Email of person submitting this form:
*
example@example.com
Date submitted:
*
-
Month
-
Day
Year
Date
For Office use only:
District Superintendent signature of approval: Date:
Print
Save For Later
Submit
Should be Empty: