Form 11 - Clergy Profile on Continuing Formation

Clergy Profile on Continuing Formation Susquehanna Conference – Board of Ordained Ministry

For the period beginning January 1, 2025 and ending December 31, 2025
Due January 31, 2026

Report all Professional & Skill Development and Spiritual Formation Events. Attach copies of certificates or evidence of courses completed for this reporting year. Continue onto additional pages as necessary. Conference policy is to attain 10 CEUs per quadrennium.
Charge
District
District Email
example@example.com
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Date

MonthDayYear
Date
Present Appointment and/or Ministry Location
Total CEU's this year
Total CEU's this Quadrennium (2022-2025)
COS Classes Completed (if applicable)

Spiritual Formation Events

Professional & Skill Development

	Professional & Skill Development	Date Completed	# of CEU's granted	Issuing Institution
1
2
3
4

Boundaries training is required every four years. Date of most recent Boundaries training:

MonthDayYear
Date
Form Submission Info

Who is filling this out and where will the final PDF be sent
Name

First NameLast Name
Email
example@example.com
Should be Empty:

Clergy Profile on Continuing Formation Susquehanna Conference – Board of Ordained Ministry