The United Methodist Church Biographical Information Form Page 3

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THE UNITED METHODIST CHURCH
BIOGRAPHICAL INFORMATION FORM
Your childhood family and other significant relatives:
Marital
Name
Relation
Age
Education
Sex/Gender
Occupation
Status
Father
Mother
Work Experience: (current employment, previous employment, and military experience, if any.)
Have you served as a local pastor, diaconal minister, deacon or elder in The United Methodist Church? Yes
No
If Yes, what Conference?________________________________________________________
Conference Relationship
DATE
DATE
Consecrated Diaconal Minister
Provisional Member
License as a Local Pastor
Deacon in Full
Connection
Associate Member
Elder in Full
Connection
Have you had a change in clergy relationship with a conference of The United Methodist Church? Yes
No
Change in Conference Relationship
DATE
DATE
Discontinuance
Location
Leave of Absence
Retirement
Medical Leave
Withdrawal
Termination by action of the
annual conference
Note: If additional space is needed please use a separate sheet of paper and attach this form.
BOM Handbook, Chapter 8, Candidacy and Candidacy Forms
Form 102/2013

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