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Purchase a Church to Make It a Home

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					Name
                                 (last name - first name - middle initial)                                        (town/city plus church name)
District                                                    For district fiscal year ending                                                                  2010

                                                                THE WESLEYAN CHURCH
                                                              Pastor's Annual Service Report
                                                                To the District Conference
         INSTRUCTIONS: Every pastor shall submit this report to the district board of ministerial development at the time designated by the district
         (Discipline 1390:7-8; 1402). Associate and assistant pastors shall complete an “Associate/ Assistant Pastor’s Annual Service Report.” If you need
         more space in any box, go to "Additional Remarks" tab at the bottom of this form and type your comments there.

                                                                             A. Labors
1. Have you sought faithfully by your personal dealings and by your public ministry to lead sinners to a saving knowledge of Jesus Christ?
   To lead believers into the experience of entire sanctification?

2. Have you provided shepherding, discipling, and pastoral care to your congregation, designed to establish in faith, prepare for service, and retain to the

    body?                            If so, please describe briefly.



3. Have you endeavored to involve your people in a personal visitation, soul-winning, and/or outreach program?
   If so, please describe briefly.



4. Have you presented the truth of Christian stewardship and storehouse tithing to your congregation (460-465; 725:22)?
5. In self-evaluation, how would you assess your affirmation of loyalty to these agencies of the Church:
    a. General Church                                          b. District                               c. Educational Institutions

    If your assessment is "medium" or "low" it suggests you may have recommendations to offer. Please explain:



6. Name the primary source(s) from which you purchase Sunday School literature.


7. Are your church records carefully maintained as tools to facilitate present administration and to acquaint your successor with the state of the work?
    (725:30)?

                                                                B. Personal Responsibilities
8. Have you endeavored to live a life that is blameless and above reproach, thereby providing a good example of the life-style and conduct required by the
     Membership Commitments of The Wesleyan Church (260; 265)?

9. Are you currently involved in a relationship, questionable activity or addiction, which, if not properly addressed, will harm or destroy your ministry?



10. Is your personal spiritual relationship with Christ continuing to grow or has it plateaued?
      Give testimony of new victories or requests for special needs.


11. Are you fully committed to uphold the doctrines of The Wesleyan Church, its Articles of Religion and Membership Commitments as defined in
     The Discipline ?

     Are there unresolved problems (represented by questions 8, 9, 10 or 11) for which you would welcome or need counsel?

      If yes, would you be willing to seek counsel and therapy through the direction of the DBMD, or other appropriately sponsored/approved district

     referral program?

12. Is it your purpose to be effective in the practice of personal evangelism?                         Have you a related testimony or request to share?




13. Continuing education:
       a. What continuing education goals have you achieved this past year?



       b. Does your church make funding provisions for your continuing education?

14. Have you faithfully tithed your income to The Wesleyan Church during this past year?




                                                                   C. Legal Accountabilities
15. Of what nation are you a citizen?
16. If you are not a citizen of the country where you currently reside, what is your current visa or immigration status?


17. Since your last report to the district conference, have you been accused or found guilty of any criminal activity? If yes, please explain:


18. Since your last report, have you participated in, or been accused of, any sexual misconduct (such as fornication, adultery, child abuse
        [pedophilia], the sexual abuse of adolescent minors or homosexuality)? If yes, please explain:



19. Are there any pending legal actions which might incriminate you in the future? If yes, please explain:


                                                                             D. Outlook
20. a. What areas near your church should be considered as possible sites for new congregations?


        b. Have you challenged your church to sponsor such a church planting?

21. Are you ready to renew or accept appointment (3250) at the hand of the conference again this year?                                   If not, why not?




22. Are you requesting a change in your category of appointment or district relations (1240)?                                    If so, please state what change

         you desire.


                                                                  E. Statistics and Reports
23. Have you forwarded statistical and other reports as required by the district superintendent (1310:24)?
24. Are you prepared to submit in timely fashion a complete LOCAL CHURCH STATISTICAL REPORT to the district statistician(s) for the past
       year (725:32; 1352:1)?

25. Is your church paying its budget obligation to the district in full?                           For the General Church (USF & USF-EIF) in full?
         If not, please tell what procedures are being followed to meet this responsibility.


26. What percentage of total giving did your church designate for support of Wesleyan Missions (World Missions and Home Missions combined)
         last year?                                                   (Divide the total given to Wesleyan Missions by the total contributions for all purposes to
        determine percent.) What is the church's percentage goal for the next year?

27. Is your church providing health insurance?                                            If not, why?



28. Is your church paying 12% pension assessment for the WESLEYAN PENSION FUND in full for the pastor?

        For the associate/assistant pastor(s) ?                        For the eligible Wesleyan evangelists?                             If not, please explain:



                                                                   F. Personal Information
29.   SIGNATURE
      [Submission of this report by e-mail constitutes validation of electronic
       signature]
30. Mailing Address (Street or P.O. Box)
31. City/State or Province/Postal Code
32. Home Address (if different from mailing address)
33. City/State or Province/Postal Code
34. Home Telephone                                                                      35. Year of ordination:
36. Cell phone number                                                                   37. Secular work phone number
38. Fax                                                                                 39. Email address:
40. Name of local Wesleyan Church, city and district where your
      covenant membership currently resides in good standing.
41. If not a covenant member of The Wesleyan Church, name of the
      local church, address and denomination affiliation where
      church membership currently resides in good standing.


                       WHEN YOU HAVE COMPLETED THIS DOCUMENT, BE SURE TO PRINT AND SAVE A COPY FOR YOUR RECORDS.
42. Type of pastoral employment [check one]                                             Full-time pastor without other employment
                                                                                        Full-time pastor with other employment
                                                                                        Part-time pastor without other employment
                                                                      Part-time pastor with other employment
43. Length of time in your current assignment                Years:                  Months:

44. Your gender                                 45. Your birth date
Use this sheet to write in additional information as needed
Atlantic                 January        1                 Yes   District Superintendent
Central Canada           February       2       2009      No    Full-time Assist. Dist. Supt.
Central New York         March          3                       Full-time Other Dist. Ministry
Chesapeake               April          4                       Affiliate Dist Supt
Colorado-Nebraska        May            5                       Senior Pastor
Dakota                   June           6                       Pastor
East Michigan            July           7                       Co-Pastor
Eastern NY New England   August         8     High              Associate Pastor
Florida                  September      9     Moderate          Assistant Pastor
Greater Ohio             October       10     Low               Youth Pastor
Illinois                 November      11                       Minister of Music
Indiana Central          December      12                       Minister of Visitation
Indiana North                          13     Growing           Minister of Admin.
Indiana South                          14     Plateaued         Minister of Christian Ed.
Iowa-Minnesota                         15                       Minister of Pastoral Care
Kansas                                 16                       Minister of Evangelism
Kentucky                               17                       Supply Pastor, Wesleyan
North Carolina East                    18                       Supply Pastor, Non-Wesleyan
North Carolina West                    19                       Supply Pastor, Lay
North Michigan                         20                       Sup Past on loan fm other dist.
Northwest                              21                       Sup Past in proc of denom trans
Pacific Southwest                      22                       Asst. Sup. Past in proc of denom trans
Penn-Jersey                            23                       Pastor, applied for dist. trans.
Shenandoah                             24                       Pastor, pend comple of dist trans
South Carolina                         25                       Ministerial Student, Sup. Past.
South Coastal                          26                       Min. Student, Asst Sup Pastor
Southwest Hispanic                     27                       Associate General Evangelist
Tennessee                              28                       General Evangelist
Texas-Louisiana                        29                       Reserve General Evangelist
Tri-State                              30                       Administrator - General Church
West Michigan                          31                       Empyed by Headq. or sub. corp.
Western New York                                                Educator in Wes Ch Ed. Inst.
Western Pennsylvania                                            Interchurch Service
Wisconsin                             Male                      Special Service
                                     Female                     Chaplain
                                                                Missionary in TWC
                                                                Other Service
                                                                Intinerate Bible Teacher
                                                                Ord. Min on ed. leave
                                                                Ordained Minister on reserve
                                                                Retired Minister
                                                                Short-term Missionary
                                                                Min in proc of transf from another denom
                                                                and not under past. appt.
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                               2009
erintendent                    2008
sist. Dist. Supt.              2007
her Dist. Ministry             2006
 Supt                          2005
or                             2004
                               2003
                               2002
astor                          2001
astor                          2000
 r                             1999
Music                          1998
 isitation                     1997
 dmin.                         1996
Christian Ed.                  1995
 astoral Care                  1994
 vangelism                     1993
 or, Wesleyan                  1992
 or, Non-Wesleyan              1991
 or, Lay                       1990
 loan fm other dist.           1989
 proc of denom trans           1988
 ast in proc of denom trans    1987
 ed for dist. trans.           1986
d comple of dist trans         1985
 tudent, Sup. Past.            1984
t, Asst Sup Pastor             1983
 eneral Evangelist             1982
 ngelist                       1981
neral Evangelist               1980
 r - General Church            1979
Headq. or sub. corp.           1978
 Wes Ch Ed. Inst.              1977
Service                        1976
vice                           1975
                               1974
n TWC                          1973
 e                             1972
 ble Teacher                   1971
 ed. leave                     1970
 nister on reserve             1969
ster                           1968
Missionary                     1967
of transf from another denom   1966
er past. appt.                 1965
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