Board of Lay Ministry: Form 01 For use only when LM is appointed to a local church as a supply pastor
Certified Lay Minister (LM) Supervisory Agreement with the District Superintendent Name:
______________________________________________________________________ First Middle Last
Address:
______________________________________________________________________ Street City State Zip
Best Contact # __________________________ Birthdate: [__] Cell [__] Home [__] Work Email:
_________ _________ __________ Month Day Year
______________________________________________________________________
As a Certified Lay Minister (LM), I have been asked to serve the following: District
AP
CM
HI
Charge Church 1
MV
NR
SS
SM
TV
TR
Church 2
Street
Street
City
City
State Zip
State Zip
Worship Time Frequency Weekly Monthly Church 3
Bi‐weekly
Worship Time Frequency
Street
City
City
State Zip
State Zip
FORM 17‐LM Supervisory Agreement
Bi‐weekly
Weekly Monthly
Bi‐weekly
Church 4
Street
Worship Time Frequency Weekly Monthly
Weekly Monthly
Bi‐weekly
Worship Time Frequency
Revised: 2020‐05‐07
Board of Lay Ministry: Form 01 For use only when LM is appointed to a local church as a supply pastor
I realize that I am a lay person and that I am not allowed to administer the sacraments of Baptism or Holy Communion. However, I understand that I can serve the elements if they have been consecrated by and Elder. I also realize that I will not be able to perform weddings, since I am not a licensed pastor. I realize that I will be expected to act like a minister and will have, at least, the following responsibilities: Home & Hospital Visitation Conducting and Leading Worship Administration of the Church: Charge Conference and Year End Reports Attend District Minister’s Meetings
Performing Funerals Overseeing/Conducting Church Meetings Meet, as requested, with the DCOM Maintain an up to date Safe Gatherings Certification
In addition to the above items, I understand that the District Superintendent expects the following from me as I minister at the charge to which I have been assigned:
___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ________________________________________________ LM Signature
________________________________ Date
________________________________________________ DS Signature
________________________________ Date
A copy will be given to the Certified Lay Minister (LM) and will be kept:
In this person’s DCOM files In this person’s supervisory files within the District Superintendent’s office
FORM 17‐LM Supervisory Agreement
Revised: 2020‐05‐07