2024 Request for Renewal of Standing for Ministers

2024 Request for Renewal of Standing for Ministers

Ministers desiring to maintain their standing in the Georgia Region need to complete and return this form by February 29, 2024. This form is for ALL commissioned and ordained clergy in the Christian Church (Disciples of Christ) in Georgia. Should you have any questions, please contact Ja’Lisa Jarvis, Administrative Assistant, to assist you at 478.743.8649 or jalisa@gadisciples.org.
Full Legal Name:

First NameMiddle NameLast Name
Name as it should appear on my 2024 Standing:
Primary Phone Number:
(Home/Cell/Work)
Secondary Phone Number, if applicable:
(Home/Cell/Work)
Preferred Email Address:
example@example.com
Is the above email address your home (personal) email or office email?

Home (personal)Office
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
My age range as of last birthday (check one range):

24-2930-3940-4950-5960-6970+
Do you have a job outside of the Congregation?
If yes, how many hours?
Name of Congregation/Institution you serve:
Address of Congregation/Institution you serve:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Congregation/Institution Website:
In the Christian Church (Disciples of Christ) in Georgia, I serve as:

Ordained Active (indicate title/position in next prompt)Commissioned Active (indicate title/position in next prompt)Ordained Retired Active (indicate title/position in next prompt)Ordained Retired Inactive (if checked, please skip to the end, sign, and date)Commissioned Retired Inactive (if checked, please skip to the end, sign, and date)
Title/Position:
Christian Church (Disciples of Christ) Ordination Date:

MonthDayYear
Date
Ordained by another denomination (specify denomination):
Ordination recognized and Standing certified on

date by: or by General Commission on Ministry (GCOM).
I currently serve as (check the title/position designated by GCOM; if serving in multiple ministerial positions, select primary one for reporting to Year Book):

Chaplain – FederalChaplain – Non-federalStudent ChaplainMinister of Recognized CongregationAssociate MinisterInterim MinisterStudent MinisterStudent Associate MinisterNon-parish MinisterMusic MinisterDisciples Minister serving non-Disciples congregationMinister of CounselingOther employment though still preaching
The Christian Church (Disciples of Christ) seeks to be a pro-reconciling/anti-racist church. To that end, we seek to maintain an understanding of the diversity of the servants who are leading the church in various ministries. Please mark the ethnicity choice(s) appropriate for you.

African-AmericanAsianNative American/First NationsHaitianHispanicPacific IslanderEuropean DescentMiddle EasternI decline to answer this question
Other:
I have reviewed and will adhere to the Ministerial Code of Ethics of the Christian Church (Disciples of Christ).

YesNo
Document available to review here.
I have reviewed and will adhere to the Georgia Region’s Policy on Clergy Sexual Misconduct.

YesNo
Document available to review here.
I have reviewed and will adhere to the Administrative Policy on Violation of Ministerial Ethics.

YesNo
I will be a faithful minister serving within and supportive of the Christian Church (Disciples of Christ).

YesNo
Certification for ministry includes participation in "programs of study, growth, and renewal" (Theological Foundations and Policies and Criteria for the Ordering of Ministry: Section 11. F.2. b.ii.). Indicate programs in which you have participated in the past 12 months. In the past year, I have participated in (please check ALL that apply):

Personal Spiritual RetreatClergy RetreatEcumenical eventsGeneral AssemblyRegional AssemblyYouth, Adult, or other church camp experienceNational ConvocationOutdoor MinistriesObra HispanaClergy ConnectionsUpgrade ThursdaysRegular reading of professional literature. List books and journals, especially those you recommend, below.
Professional Literature/Books/Journals:
Other programs, including General and Regional offerings, of ministerial participation:
Other programs of study or research in which you have been involved this year:
I have completed Healthy Boundaries for Clergy training:

YesNo
Where/Trainer:
Date Completed:

MonthDayYear
Date
I have completed diversity and/or anti-racism training:

YesNo
Where/Trainer:
Date Completed:

MonthDayYear
Date
List other trainings and/or certifications you have received in the past year, especially those you recommend:
Passions, Interests, and Demonstrated Experience:

Commission on MinistryEcumenical DialogueCreation Care/Green ChaliceGlobal MinistriesInterfaith DialogueJustice/Peace LeadershipMarketing and CommunicationsNew Church MinistriesOutdoor MinistriesRural Church LeadershipSocial Media/Public RelationsDisciples History/PolityChildren/Youth/Young Adult LeadershipCurriculum DevelopmentConflict Resolution
Other areas of interest not listed above:
Past and current avocations and experience:
What forms of self-care do you regularly follow (i.e. exercise, spiritual retreats, vacations, etc.)?
Are there new ideas/ways/programs that you believe would strengthen the Region or serve clergy better?
Standing for ministers in active service continues so long as the minister does and reports the following: "….Maintains relations with the Christian Church (Disciples of Christ) including participating membership in a recognized congregation in the community of residence or active ministry where feasible." (Theological Foundations and Policies and Criteria for the Ordering of Ministry, Section 11.F.2.b.iii.)
I am a member of (congregation and location):
I affirm that the information I have provided is accurate. That it is my responsibility to read, to understand and to abide by the policies outlined in the Policies and Criteria of the Order of Ministry in the Christian Church (Disciples of Christ) in the US and Canada, Ministerial Code of Ethics and The Policy and Procedures of the Christian Church (Disciples of Christ) in the Georgia Region.
Signature

Powered by Jotform SignClear
Date

MonthDayYear
Date
Should be Empty: