(last name) (first name) (initial)
District Penn-Jersey For district fiscal year ending 2011
THE WESLEYAN CHURCH
Minister's Annual Service Report
To the District Conference
INSTRUCTIONS: This report is to be completed by all ministers of The Wesleyan Church who are not pastors or evangelists, (including ordained ministers,
commissioned ministers and licensed ministers) and is to be submitted to the district board of ministerial development at the time designated by the district
(Discipline 1390: 7-10; 1402). Pastors submit a "Pastor's Annual Service Report." Associate/Assistant pastors submit an "Associate/Assistant Pastor's
Service Report." Evangelists submit a "Evangelist's Service/Statistical 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.
1. To what category of service were you appointed by the district conference at its last session (3250; 3370)?
2. Describe briefly how you have served in that category of service this past conference year. (Use extra sheet of paper to complete your response if
3. 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?
4. Have you endeavored to carry out all that The Discipline requires of you as a minister in your particular field of service? (Discipline 725)
If no, please explain.
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:
B. Personal Responsibilities
6. 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)? 7. Are you currently involved in a relationship, question-
able activity or addiction, which, if not properly addressed, will harm or destroy your ministry?
8. Is your personal spiritual relationship with Christ continuing to grow or has it plateaued?
Give testimony of new victories or requests for special needs.
9. 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 6, 7, 8, or 9) 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?
10. Is it your purpose to be effective in the practice of personal evangelism? Have you a related testimony or request to share?
11. Continuing education: What continuing education goals have you achieved this past year?
12. Have you faithfully tithed your income to The Wesleyan Church during this past year?
C. Legal Accountabilities
13. Of what nation are you a citizen?
14. If you are not a citizen of the country where you currently reside, what is your current visa or immigration status?
15. Since your last report to the district conference, have you been accused or found guilty of any criminal activity? If yes, please explain:
16. 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:
17. Are there any pending legal actions which might incriminate you in the future? If yes, please explain:
18. Are you ready to renew or accept appointment (3250) at the hand of the conference again this year?
If not, why not?
19. Do you desire any change in your appointment or district conference relations (1240)? If so, please state what
change you desire.
E. Personal Information
[Submission of this report by e-mail contitutes validation of electronic
21. Mailing Address (Street or P.O. Box)
22. City/State or Province/Postal Code
23. Home Address (if different from mailing address)
24. City/State or Province/Postal Code
25. Home Telephone 26. Year of ordination
27. Telephone 28. Secular
29. Fax 30. phone
work E-mail address
31. Name of local Wesleyan Church, city and district where your
covenant membership currently resides in good standing.
32. 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.
33. Type of ministerial employment [check one] Full-time minister without other employment
Full-time minister with other employment
Part-time minister without other employment
Part-time minister with other employment
34. Length of time in your current assignment Years: Months:
35. Your gender 36. Your birth date
Use this sheet to write in additional information as needed
Atlantic January 1 2009 Yes District Superintendent
Central Canada February 2 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
Missionary in TWC
Intinerant Bible Teacher
Ord. Min on ed. leave
Ordained Minister on reserve
Min. in process of transf. from other
denom., not under previous appt.
sist. Dist. Supt. 2007
her Dist. Ministry 2006
Christian Ed. 1995
astoral Care 1994
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
neral Evangelist 1980
r - General Church 1979
Headq. or sub. corp. 1978
Wes Ch Ed. Inst. 1977
n TWC 1973
ble Teacher 1971
ed. leave 1970
nister on reserve 1969
ess of transf. from other
under previous appt. 1966