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Annual Information Review

Home
Supporting Leaders
Ministerial Authorization (Committee on Ministry)
Section B: Ministerial Oversight & Support
Annual Information Review

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Personal Information
Please include your pertinent contact details
Name*
First Middle Last
Mailing address*
Street Address Address Line 2 City State ZIP Code
UCC person ID number
Leave BLANK if unknown
Home phone
Leave BLANK if none
Mobile phone
Leave BLANK if none
Email*
My contact information may be*
- Published in the NCNC-UCC Directory and national UCC Yearbook
- Not published in the Directory or Yearbook

Ministerial Authorization & Local Church
Please include details of your current authorization for ministry, vocational engagement, and Local Church membership
The NCNC-UCC Local Church in which I hold my membership is*
Currently, my primary ministry work is*
- Serving in my local church as solo pastor
- Serving in my local church as senior pastor (head of staff with multiple clergy called/employed by the church present)
- Serving in my local church as associate pastor (called/contracted clergyperson, not serving as head of staff)
- Serving in a local church as interim pastor
- Serving in a specialized ministry setting outside of the local church
- Leave of Absence - between calls and/or doing occasional service (supply, bridge, etc)
- Leave of Absence - vocational discernment without any ministry engagement
- Retired status
- I hold Exempt Standing
Name of my ministry setting*
Address of ministry setting*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
I am in a*
- Three-Way Covenant
- Four-Way Covenant
- No Covenant is in place
My covenantal Association is*
Date of ordination/authorization in UCC*
If exact date is unknown, choose last day of appropriate month & year
Date Format: MM slash DD slash YYYY
My authorization for ministry is*
I hold an ecclesiastical endorsement*
- No
- Yes: for a professional organization
- Yes: for military chaplaincy
Name of professional organization*
Name of military branch*
Date of endorsement*
Date Format: MM slash DD slash YYYY

Vocational Reflection
Please include details of your current ministry setting, vocational support, or upcoming plans.
Describe your primary responsibilities/functions in your present ministry.*
If retired or Exempt Standing, please discuss what activities are currently bringing your life joy and meaning.
Identify continuing education experiences from this past year that have advanced your ministry skills.*
Have you completed an approved Boundary Training this year?*
- Yes (through NCNC)
- Yes (through another provider)
- No
Have you completed a Racial Justice/Anti-Racism Training this year?*
- Yes (through NCNC)
- Yes (through another provider)
- No
Have you completed the online Mandated Reporter Training this year?*
- Yes (Initial + Clergy Specific)
- Yes (Clergy Specific only)
- No
Would you like to update your Lifelong Learning record at this time?*
- Yes (will take you to the Lifelong Learning Update form after this form)
- No
Please describe the ongoing peer support in which you are involved at this time (i.e. Community of Practice, local ministerium, etc).*
Please describe a formative event or practice of your faith/spiritual journey this year.*
Date of most recent Periodic Vocational Support with COM-B, if known.
If exact date is unknown, choose last day of appropriate month and year.
Date Format: MM slash DD slash YYYY
How have you maintained your covenantal relationship with the United Church of Christ during the past year?*
Check all that apply
- Attended an Association meeting
- Attended Conference Annual Gathering
- Contributed financially as a Friend of the Conference
- Contributed financially to the National Setting
- Advocated for OCWM and special offerings in my Local Church of Membership
- Attended General Synod as a visitor or voting delegate
- Served on an Association/Conference/National Setting board or committee
- Served as a clergy advisor/mentor to a Member in Discernment
- Other
Please describe your other covenantal relationship, selected above*
In your own vocational discernment, do you anticipate any of the following in the coming year?
Check any and all that apply
- Beginning the Search Process for a new ecclesial position
- Resigning my current ecclesial ministry and searching for secular employment
- Beginning/returning to a formal academic program (i.e. DMin, etc)
- Retiring from active ministry
- Seeking Exempt Standing and fully disengaging from public ministry
When (date/season of year) are you considering retirement?
When (date/season of year) are you considering resignation?
Are there any covenantal connections you desire in this year?
Check any/all that apply
- I'd like to schedule a Periodic Vocational Support meeting with COM-B
- I'd like to schedule a time to speak with an Associate Conference Minister
- I'd like to join a Community of Practice
- I'd like to schedule Pastoral Coaching sessions
- I'd like to be considered for Association/Conference boards/committees
- I'd like to be considered as a Conference nominee for National UCC leadership positions/General Synod delegations
- I'd like to know about volunteer opportunities in the Conference other than boards/committees
Signature

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