Form TC 410 ST Page 1 of 3 June 2017 – v5

The United Church of Canada

L’Eglise Unie Du Canada

Toronto COnference

Request for Short-term Supply or

Interim Ministry Appointment(TC 410 ST)

Purpose:To request short-term supply appointment or interim ministry appointment.

Who uses it: Community of Faith (CoF)

When to use this form:Following a change of pastoral relations, and when the Community of Faith is ready

for a short-term supply appointment or Interim appointment.

When NOT to use form:When declaring a vacancy.

ROUTING:Please keep a copy for your records prior to sending on.

□The Community of Faithcompletes Part A and B and sends original to presbytery.

□Presbytery completes Part C and sends original to the Settlement and Pastoral Relations Committee administrative assistant.

□Toronto Conference Settlement and Pastoral Relations Committeecompletes Part D and sends original to presbytery office and a copy to the local ministry unit.

Part A: COMMUNITY OF FAITH INFORMATION

Name of Community of Faith______

Name of presbytery______

We request: supply minister*interim minister**

 the position description for a short term supply appointment is attached (TC425PD)

Clarification of terms:

* A supply minister is appointed on a time-limited basis, usually one year.

** An interim minister has specific training to do interim ministry.

“When a congregation cannot continue its mission as usual, interim ministry is a way to take an intentional “time out” to seek renewal and make a significant change in its organizational structure, its mission, or its pastoral life.” (from the UCC Interim Ministry Handbook)

PART B: INTERVIEW TEAM*(Short-term Supply) - or –

TRANSITION TEAM*(Interim Ministry Appointment)

Once a Conference Settlement Liaison is appointed, they will be in touch with the contact person below:

Contact NameEmailPhone

NameEmailPhone

NameEmailPhone

NameEmailPhone

NameEmailPhone

*Please review the guidelines of who should or should not be on the interview team in Step 1 of the Community of Faith Handbook Seeking New Call or Appointment.

At a meeting of the governing body on ______(yyyy/mm/dd), the above interview/transition team was named.

yyyy/mm/ddSignature of chair or secretary of governing body Printed Name

OR (Instead of a signature you may fill in the details of the governing body’s motion in this section)

Mover______/ Seconder ______that

Date the governing body approved the above named interview team/transition team: ______/______/______

(yyyy/mm/dd).

Name of Chairperson: ______
PART C:ACTION BY PRESBYTERY

______Presbytery:

 has ensured that a position description is in place and requests a settlement liaison be appointed.

When Interim Ministry is requested:

 Presbytery appoints the following members to the transition team:

NameEmailPhone

NameEmailPhone

yyyy/mm/ddSignature of presbytery designatePrinted Name

PART D:ACTION BY TORONTO CONFERENCE

 A Settlement Liaison has been appointed as follows:

NameEmailPhone

yyyy/mm/ddSignature of Settlement and Pastoral Relations designatePrinted Name

The use, retention and disclosure of personal information collected from this form is done in compliance with privacy legislation including, but not limited to, the Personal Information Protection and Electronic Documents Act (1000,c.5). THIS FORM IS NOT VALID IF ALTERED.