Registration Form Deadline: December 1, 2021
2022 Candidacy Summit Registration Form
Candidate Name: ___________________________________________________________________________ Gender:
[__] Male [__] Female [__] Non‐Binary
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: ______________________________________________________________ Mail to: Holston Conference, Office of Clergy Services % Brandy Williams PO Box 805 Alcoa, TN 37701‐0850 Questions: Brandy Williams BrandyWilliams@holston.org
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Updated: 2021-10