2023 Extension Ministry Form This is reporting from January 1, 2023 – June 30, 2024 Part 1 – Appointment to an Extension MinistryName* First Middle Last Business Phone*Home Phone*Cell Phone*Email* Enter Email Confirm Email Title/Position*Agency/Institution*Business Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Preferred address for business purposes and for inclusion in Journal* Business Home Base Compensation for Year 2023*Utilities and other Housing Related Allowances for Year 2023*Travel Allowance for Year 2023*Other Cash Allowances for Year 2023*Status:* Full Member Provisional Member Associate Member Local Pastor Full member of North Carolina Annual Conference* Yes No Name of church where your Charge Conference Membership is held*District* Beacon Capital Corridor Fairway Gateway Harbor Heritage Sound If you are under appointment outside the conference of which you are a member, please enter the Conference where you serve, and Bishop's name.District and District Superintendent where you serveAffiliate Charge Conference Membership where you servePlease indicate your Appointment Category (¶344.1) a. Appointed within the connectional structure b. Endorsed by the UM Endorsing Agency within the General Board of Higher Education and Ministry c. In service with General Board Global Ministries d. Appointed to other valid approved extension ministry Deacons: Please indicate your Appointment Category (¶331.1) a. Deacons Appointed Beyond the Local Church b. Deacons Endorsed by the UM Endorsing Agency within the General Board of Higher Education and Ministry Write a brief narrative of your ministry during the past year. If you prefer to upload your written document instead of typing in this text box, please press Choose File below this text box.Max. file size: 49 MB.Annual Evaluation File – A copy of your annual evaluation can be uploaded thru Choose File or mailed to NC Conference, Attn: Office of Clergy Life, 700 Waterfield Ridge Place, Garner, NC 27529 and if your Appointment Category is (b.) then also send to United Methodist Endorsing Agency, PO Box 340007, Nashville, TN 37203-0007.Max. file size: 49 MB.List evidence of your continuing education and spiritual growth program and future plans (¶344.2). If you prefer to upload your written document instead of typing in this text box, please press Choose File below this text box.Max. file size: 49 MB.Part 2 – QuestionnaireIn what ways do you consider a Theological Education, Ordination and Conference Membership necessary to your work?*How long have you been in your present position?*Did you attend and report to the Charge Conference in 2023?* Yes No Do you understand that, as a member of the North Carolina Conference, it is your duty to attend the Annual Conference Session? (¶344.5d, 329.2, 2016 Discipline)* Yes No What was the year of the last NC Conference Session you attended?*If you were unable to attend the most recent session of our NC Conference at the Greenville Convention Center, June 13-15, 2024, did you provide written letter/email/response indicating your absence? If not, please do so and send to clergylife@nccumc.org by August 1st. If you were absent without a satisfactory reason for the absence, the matter shall be referred by the Conference Secretary to the Board of Ordained Ministry – ¶602.8, 2016 Discipline. This applies even if you have to be absent one day. You will be expected to be in attendance unless you notify us of your absence.If you are employed outside the North Carolina Conference, in what ways have you sought the relationship with the Bishop in the Area in which you reside, as described in ¶344.2a, 331.4d, 2016 Discipline?Have you sent him/her a copy of this report? Yes No REPORT OF ACTIVITIES: January 1, 2023 through June 30, 2024. Describe any additional activities during the year, or add any word of explanation or additional information, if you would like to do so. If you prefer to upload your written document instead of typing in this text box, please press Choose File below this text box.REPORT OF ACTIVITIES FILEMax. file size: 49 MB.Number of persons to whom you minister:*Number worship services conducted or assisted in:*Number sermons preached:*Number Church School classes taught:*Number Leadership Training classes taught:*Number Confirmation Classes conducted:*Number Communion Services celebrated or assisted in:*Number baptisms performed or assisted with:*Number marriages performed or assisted with:*Number funerals conducted or assisted with:*Part 3 – Committee ReportEffective May 2007, THE EXTENSION MINISTRY COMMITTEE of the North Carolina Conference Board of Ordained Ministry requires the completion of this form as a part of your connection to the conference and in addition to those required by the Bishop’s Office and the GBHEM. You may want to refer to the historic examination questions listed in ¶336 of the Book of Discipline and the ordination service examination in the Book of Worship (pp. 674-678) in answering the following: How has the practice of ministry, in your setting through Extension Ministries, affirmed your call to ordained ministry and helped you live out your call in faithfulness to your ordination vows?*CommentsThis field is for validation purposes and should be left unchanged.
