Form 15 Supply Preacher (SY) Supervisory Agreement with the District Superintendent Name:
______________________________________________________________________
First
Address:
Middle
Last
______________________________________________________________________ Street
City
Best Contact # (______)________-__________ [__] Cell [__] Home [__] Work Email:
Birthdate:
State
Zip
_________ _________ __________ Month
Day
Year
______________________________________________________________________
As a Supply Pastor, I have been asked to serve the following: District: [__] AP [__] CM [__] HI [__] MV [__] NR [__] SS [__] SM [__] TV [__] TR Charge Church 1
Church 2
Street
Street
City
City
State Zip
State Zip
Worship Time Frequency
Worship Time Frequency
Church 3
Weekly Monthly
Bi-weekly
Church 4
Street
Street
City
City
State Zip
State Zip
Worship Time Frequency
Weekly Monthly
Bi-weekly
Worship Time Frequency
Weekly Monthly
Bi-weekly
Weekly Monthly
Bi-weekly
Please submit to: [__] The Office of Clergy Services via ClergyServices@holston.org [__] DCOM [__] Supervisory file at the District Superintendent’s office 1 of 2
Updated: 2020-11
Form 15 Supply Preacher (SY) Supervisory Agreement with the District Superintendent I realize that I am a lay person and that I am not allowed to administer the sacraments of Baptism or Holy Communion. However, I understand that I can serve the elements if they have been consecrated by an Elder. I also realize that I will not be able to perform weddings, since I am not a licensed pastor. I realize that I will be expected to act as a pastor and will have, at least, the following responsibilities:
[__] Home & Hospital Visitation [__] Conducting and Leading Worship [__] Administration of the Church: Charge Conference and Year End Reports [__] Attend District Minister’s Meetings
[__] Performing Funerals [__] Overseeing/Conducting Church Meetings [__] Meet, as requested, with the DCOM [__] Maintain an up to date Safe Gatherings Certification
In addition to the above items, I understand that the District Superintendent expects the following from me as I minister at the charge to which I have been assigned: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________
_______________________________ _______________________________ ___________________ Signature Printed Name Date _______________________________ _______________________________ ___________________ Signature Printed Name Date District Superintendent
Please submit to: [__] The Office of Clergy Services via ClergyServices@holston.org [__] DCOM [__] Supervisory file at the District Superintendent’s office 2 of 2
Updated: 2020-11