Registration Form Deadline: December 1, 2020
2021 Candidacy Summit Registration Form
Candidate Name: ________________________________________________________ [__] Male [__] Female Email address:
___________________________________________________________________________
Address:
___________________________________________________________________________ Street City, State Zip
Phone number:
(______) ________‐____________ Church: ______________________________________
District:
[__] AP [__] CM [__] HI [__] MV [__] NR [__] SS [__] SM [__] TV [__] TR
Are you currently living outside of your home district (away at seminary, etc)? If so, where and why: ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Primary language: ___________________________________________________________________________ Other language(s) you speak, if any: ______________________________________________________________ Items to include when mailing this completed Registration form in: [__] Completed Registration Form [__] Mail to: Holston Conference, Office of Clergy Services % Brandy Williams PO Box 805 Alcoa, TN 37701‐0850 Questions: Brandy Williams 865‐293‐4148 Direct or BrandyWilliams@holston.org
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Update: 2020-11