Application to come off of Voluntary Leave of Absence (VLOA)
Name: First Middle Last Address: Street City State Zip
Best Contact # (______)________-__________ Birthdate: _________ _________ __________ [__] Cell [__] Home [__] Work Month Day Year
Email:
Clergy Status: [__] Full Elder [__] Full Deacon [__] Provisional Member [__] Associate Member
District: [__] AP [__] CM [__] NR [__] SS [__] SM [__] TV
Charge:
After careful thought, prayer and consideration, I believe that it is time for me to come off of voluntary leave of absence (VLOA) and resume serving under appointment.
Initial the following statement: _____ I have attached a written request stating the detailed reasons for my request to come off of VLOA.
I desire for this request to become effective: _________ _________ __________ Month Day Year
Please remember that this request should be submitted six months prior to the above-mentioned date or the date of annual conference.
Signature Printed Name
Date
Please submit to: [__] Chair, Board of Ordained Ministry [__] The Office of the Bishop [__] The Office of Clergy Services via ClergyServices@holston.org [__] Current District Superintendent
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2025-07