App 07 - Join HAC Residency in Ministry (RIM)

Page 1

App 07 Application to join the Residency in Ministry (RIM) of Holston Annual Conference Name:

Address:

______________________________________________________________________

First

Middle

Last

______________________________________________________________________ Street

Best Contact # (______)________-__________ [__] Cell [__] Home [__] Work

City

Birthdate:

State

Zip

_________ _________ __________ Month

Day

Year

Email:

______________________________________________________________________

District:

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

Appointment: ______________________________________________________________________ Relationship:

[__] Provisional Deacon (PD) [__] Provisional Elder (PE)

[__] Associate Member (AM)

Having completed all seminary requirements and having been elected as a Provisional Member of the annual conference, I desire to be included in the RIM Cohort formed following annual conference. I realize that RIM is required for the three years of the Provisional process and that there will be mandatory sessions that I must attend along with other between session assignments.

___________________________________________ Signature

__________________________ Date

Please note, this is not a DCOM form. Please submit to:

[__] The Office of the BOM Registrar via ClergyServices@holston.org [__] Director of RIM via revddh@gmail.com 1 of 1

Updated: 2020-11


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