FORM 04a: Report of Candidacy Summit – Mentor and Candidate

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Report of Candidacy Summit Mentor and Candidate

Applicant Name: _____________________________________________________________________

Email address: ____________________________________________________________________

District: [__] AP [__] CM [__] HI [__] MV [__] NR [__] SS [__] SM [__] TV [__] TR

Date attended Candidacy Summit: ________________________________________________________

General Instructions:

 The Candidate is responsible for providing a copy to the appropriate DCOM registrar.

 This form allows you to provide information to the District Committee of Ordained Ministry as the candidate applies for Certification as a Candidate for Licensed or Ordained Ministry.

1. Did the candidate participate in all Candidacy Summit mentoring sessions? If not, please indicate why and how the missed session was covered by the candidate and mentor.

2. Describe the grace, gifts, fruit, and promise the candidate has for effectiveness in licensed or ordained ministry.

3. What additional information will help the district committee understand the candidate and his or her desire to be certified as a candidate for licensed or ordained ministry or continued as a certified candidate?

Signature of Candidacy Mentor Printed Name of Candidacy Mentor

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