Bishop Report Form

2020 Bishop's Report Form
Please help the NC Synod be Church together more effectively by completing this form by March 15, 2021
Name

Prefix First Name Middle Name Last Name
Birth Date

Month Day Year
Gender
Leader Key
You may now save your work and finish later. Click the "Save" button below or on subsequent pages.

Page 2
Ordination/Consecration Date

Month Day Year
Baptismal Date

Month Day Year
Marital Status
Spouse Date of Birth

Month Day Year
Date
Name of Spouse

Prefix First Name Middle Name Last Name
Home Postal Address

PO Box or Street Address

Street Address Line 2

City State

Zip Code
Mobile Number

Area Code Phone Number
Home Phone

Area Code Phone Number
Work Number

Area Code Phone Number
Personal E-mail
Professional Email
(at your employer)
Preferred Phone

Work Mobile Home
Preferred E-mail

Personal Professional
Can you receive text messages on your mobile phone?

Yes No
Please list your children:
Enter children with DoB. Also anything else that would be pertinent.
(If you choose a retired status, you will skip to page 6 when you click "Next".)
My status is:

Page 5
Needs
What area of the Wholeness Wheel needs the most attention from you in 2021?

(Wholeness Wheel link)
Wholeness Wheel areas: (Choose an area of well being from the list)
What I need most from the NC Synod staff is:
What my congregation needs most from the NC Synod staff is:

Page 6
For Retired only
(others click "Next" to continue on next page)
Personal Church Membership
Short Name, City
What pastoral ministry were you invited to provide this past year? Did you enjoy it?
What insights into church life, based upon your experience, would be helpful for the bishop's consideration?

Page 7
All fill in this page
I want to make sure my bishop knows:
What excites you on a synodical or churchwide level?
Answer here
Are there individuals in your congregation with gifts for rostered ministry? Please list their name, their gifts, and their contact info.
Type Name, E-mail, Phone for each
Are there individuals in your congregation that you would recommend to serve on a synod committee or task force? Please list their name, committee of interest, and their contact info.
Type Name, Gifts, E-mail, Phone, Team
How might we pray for you in 2021?
You're done. Click the "Submit Report" button to finish.
Should be Empty:

2020 Bishop's Report Form