App 11 Application to come off of Voluntary Leave of Absence (VLOA) Name: Address:
______________________________________________________________________
First
Middle
Street
City
Best Contact # (______)________-__________ [__] Cell [__] Home [__] Work Email:
Last
______________________________________________________________________ Birthdate:
State
Zip
_________ _________ __________ Month
Day
Year
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Clergy Status: [__] Full Elder [__] Full Deacon [__] Provisional Member [__] Associate Member District:
[__] AP [__] CM [__] HI [__] MV [__] NR [__] SS [__] SM [__] TV [__] TR
Charge:
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After careful thought, prayer and consideration, I believe that it is time for me to come off of voluntary leave of absence (VLOA) and resume serving under appointment. Initial the following statement: _____ I have attached a written request stating the detailed reasons for my request to come off of VLOA. I desire for this request to become effective:
__________________________ Signature
_________ _________ __________ Month Day Year Please remember that this request should be submitted six months prior to the above-mentioned date or the date of annual conference.
_________________________ Printed Name
___________________ Date
Please submit to: [__] Chair, Board of Ordained Ministry [__] The Office of the Bishop [__] The Office of Clergy Services via ClergyServices@holston.org [__] Current District Superintendent 1 of 1
Updated: 2020-11