App 05 Application to become a Supply Preacher (SY) Name:
Address:
______________________________________________________________________
First
Middle
Last
______________________________________________________________________ Street
City
Best Contact # (______)________-__________ [__] Cell [__] Home [__] Work
Birthdate:
State
Zip
_________ _________ __________ Month
Day
Year
Email:
______________________________________________________________________
District:
[__] AP [__] CM [__] HI [__] MV [__] NR [__] SS [__] SM [__] TV [__] TR
As a lay person, I have felt the call of God to offer myself in service to the church. I hereby make myself available to the annual conference for use as a supply pastor. I realize that this is a position that can end at any time and that I will be assigned by the District Superintendent to this role and will be amenable to the District Superintendent for the manner in which I conduct the ministry with the church(es) to which I have been assigned. I agree to adhere to the Supply Pastor Supervisory Agreement (Form 15) that I will complete with the District Superintendent. I also understand that I may not remain in this position for more than one year, unless I am serving Âź time or less.
_____________________________________________ Signature
__________________________ Date
_____________________________________________ DS Signature
__________________________ Date
FOR DCOM USE:
__________________________
Date of initial meeting with DCOM:
Does DCOM recommend this person as a Supply Pastor (SY)? [__] Yes [__] No (list reasons) _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________
Please submit to:
[__] The Office of Clergy Services via ClergyServices@holston.org [__] DCOM 1 of 1
Updated: 2020-11