dCOM Action Report Form
Use this form for Admitted Candidates, Certified Candidates, and LLPs
District
*
Please Select
Coastal Virginia
Living Waters
Mission Rivers
Mountain View
Northern Virginia
Shenandoah River
Three Notch'd
Valley Ridge
Person Completing Form
*
First Name
Last Name
Name of District Registrar (if different from above)
First Name
Last Name
Registrar's Email
*
example@example.com
List the person who attended the meeting:
Date of Action Report
*
-
Month
-
Day
Year
Date
Candidate's Name
*
First Name
Last Name
Candidate's Church (if applicable)
Action Requested
*
Please Select
Request to be an Admitted Candidate
Certified Candidate
Certified Candidate Renewal
Transfer of Certified Candidate
Recommended for Licensing
LLP Renewal
LLP Retirement
Transfer as Minister of Other Denomination
Transfer as Other Fellowship
Withdrawal to Unite with Another Denomination
Withdrawal from the Ministerial Office
Other Denomination/Fellowship
*
Vote Count
*
Rows
Yes
No
Abstain
Votes
Admission Recommendation
*
Please Select
Grant Admission to Candidacy Studies
Not granted Admission
Not granted Admission and discontinued or withdrawn as an inquiring candidate.
Certified Candidate Recommendation
*
Please Select
Continued as an Admitted Candidate
Approval as Certified Candidate
Not granted certified candidate and discontinued as an admitted candidate.
Renewal of Certified Candidate Recommendation
*
Please Select
Renewal as a Certified Candidate
Discontinued or withdrawn as a Certified Candidate
Transfer of Certified Candidate Recommendation
*
Please Select
Approval as Certified Candidate
Not granted certified candidate status
Licensed Local Pastor Recommendation
*
Please Select
Licensing as a Full-time Pastor
Licensing as a Part-time Pastor
Not recommended for licensing
Recommended for licensing as a Student Local Pastor (see page 26 of Handbook)
Renewal of Local Pastor Recommendation
*
Please Select
Renewal as a Full-time Local Pastor
Renewal as a Part-time Local Pastor
Renewal as a local pastor on MQ16
Renewal as a Retired Local Pastor, serving an appointment
Discontinued as a local pastor, renewed as certified candidate
Discontinued as a local pastor and certified candidate.
Retirement as Local Pastor Recommendation
*
Please Select
Recommended retirement as an LLP
Not recommended retirement as an LLP
Transfer as Minister of Other Denomination/Fellowship Recommendation
*
Please Select
Transfer as a Minster of Other Denomination/Fellowship
Not transfer, assigned a clergy mentor
Withdrawal Recommendation
*
Please Select
Withdrawal
No withdrawal
Mentor/Group Mentor Assigned (as applicable)
Used for: Admitted Candidates, Recommended for licensing, or Transfers from other denominations/fellowships.
By submitting this form, the dCOM Chair or Registrar confirm the information reported is correct.
Type a question
*
Date Submitted
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: