2018Requestfor Ministerial Standing
Explanation:Inkeeping withThe Designof the ChristianChurch, Regionsare responsible for reviewingand certifying theStandingof all ordained andcommissionedDisciplesclergyeach year. WhenyourStandingisacknowledged by theRegionyour name islisted in the officialYearBook and Directoryof the ChristianChurch (Disciplesof Christ)for the ensuingyear. Ministerswith Standing maycall upontheChristianChurch forservices,support, references, relocationassistance, denominational endorsementand scholarshipaid.
SECTIONI
Name
(First) (Last)
Spouse’sName
Home Address (Address) (City) (Zip)
Home Phone ( _)
Cell Phone ( _)
Fax ( _)
Mychurchmembership isin: (ChurchName and Location)
Circle all earned degrees: AA BA/BS MA BD M.Div. D.Min. Ph.D.
Other:
Are youordained?
By whom? Date
Are youcommissioned?
By whom? Date
To the bestof your knowledge, do youcurrentlyhave ministerialStanding with the Christian
ChurchinNebraska(DisciplesofChrist)? Yes No
Date of your lastBoundaryTraining
Do youwish to continueyour ministerial Standing with theChristianChurchinNebraska(Disciples of Christ)? Yes No
What year did youbeginministryinNebraska?
Howmanyyearshave you beeninyour current position?
Presentministerial position:
I amengaged inministry: Full Time Part Time_ Supply Preaching
Interim Retired Other (explain)
MinistrySite: (Name) (Mailing Address) (City, State Zip)
Phone(_ )
Fax ( _)
Website
Whatisit about yourministryinthe past year thathasreconfirmed your callto ministry? Attach an additionalstatement, if needed, tointerpret how your work isministerial inpurpose.
SECTION II
I participated inthe followingeventsthispast year:
Regional Assembly
Disciple Men’s/Women’sRetreat
Commission, Committee,TaskGroup
BoundariesTraining
Ecumenical Efforts
Cotner College Executive Committee
CampCounselor/Director
General Assembly
Other
Describe some of the waysyourministryhasgrownand developedrecentlythroughcontinuing educationexperiences. ContinuingEducation isrequired for allministriesperSectionII.G.2.b.ii.of the Theological Foundationsand PoliciesandCriteria for theOrderingof Ministry document.
Pleaseshare how your ministryhasbeen challenging, joyousorfaithful inthe past year.
Listthe responsibilitiesacceptedandservicesperformed during thepasttwelve months.
Regional
General
Ecumenical
Howcanthecongregationof which you are amember and thePastoral LeadershipCommission be supportive of you andyourministry?
Do youhave a sabbatical program? Yes
No
Would youlike help indevelopingasabbatical program? Yes
No
Do youhave a child abusepreventionpolicy? Yes
No
Would youlike help indevelopingachild abusepreventionpolicy? Yes No
Ifyouarecurrentlyservingacongregation, do youhavea Pastoral RelationsCommittee?
Yes
No
Would youlike help developing/trainingfor aPRC? Yes
No
Do youreceiveanannualperformance review? Yes
No
Are youwilling to be a faithfulministerserving withinand supportive of the ChristianChurch
(Disciplesof Christ)? Yes
No
I have read andunderstand the followingministry policiesof theregion(availableuponrequest)
Theological Foundationsand Policiesand Criteria for theOrderingof Ministry
TheEthical Affirmations for MyMinistry
TheRegional PolicyonClergySexual Conduct
TheRegional PolicyonClergyMisconduct(Non-Sexual)
Furthermore, I understand thatthese are theoperational documentsfor thePastoral Leadership
Commission. Yes
No
For the YearBook &Directory of theChristianChurch (Disciples of Christ),pleasecheckhow you would prefer to be identified inthe listof ethniccodes(thisinformationused for statistical use only and not usedinSearch & Call):
AA-African American AS – Asian E -EuropeanDescent
HA– Haitian HI – Hispanic M -Middle Eastern
N-Native American/FirstNations O– Other P-PacificIslander
*****PersonalDisclosure Statement*****
(If the answerto anyof the following questionsisyes, please attach anexplanation)
1. Have youever been charged with orconvicted of a felony? Yes No
2. Have youever been charged with orconvicted of anycrime against childrenorother
persons? Yes
No
3.Isthere anyother factorcircumstanceinyour background that should preventyoufrom beingentrusted withthesupervision, guidance,andcare of childrenor youth?
Yes
No
Bysigning belowI certifythe informationprovidedabove isaccurate.
Signature:
Date:
Yourstanding willnot be approvedwithoutthissigneddisclosure.
Returnthisform nolaterthanFebruary 28, 2018, to:
Rev Nona Hodder, Chair of the Pastoral Relations Commission
ChristianChurch inNebraska (Disciplesof Christ)
237S70thStreet,Suite221
Lincoln,NE68510
[PLEASE KEEP A COPY OF THISFOR YOUR RECORDS]
FAILURE TO COMPLETE, SIGNAND RETURNTHISFORMBY
February 28, 2018,
WILLINDICATE THAT YOUNO LONGER DESIRESTANDING
Reviewed by:
Approved
Pending
Denied