Application For Equitable Compensation Salary Support Form Page 2
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4II.
CLERGY AND CHARGE STATUS:
a.
Clergy’s Conference Status (circle one)
AM – Associate Member
FD – Deacon in Full Connection
FE – Full Elder
FL – Full-Time Local Pastor
LP – Other Local Pastor
OA – Associate Member of Other Conference
OD – Deacon Member of Other Conference
OE – Elder Member of Other Conference
OF – Full Member of Other Denomination
OP – Provisional Member of Other Conference
PD – Provisional Deacon
PE – Provisional Elder
RA – Retired Associate Member
RD – Retired Deaon in Full Connection
RE – Retired Full Elder
RL – Retired Local Pastor
ROE – Retired Other Elder
ROF – Retired Member of Other Denomination
SP – Student Pastor
SY – Interim Supply
b.
Charge Status
If you are on a charge, please list the salary support percentages for each church. (e.g.; Smith UMC 15%, Barker UMC
42.5%, Regan UMC 42.5%)
Church #1:________________________Church #2:__________________________Church #3______________________
III.
GRANT REQUEST FOR CALENDAR YEAR ______________:
a.
Clergy Salary and Utilities to be paid by charge…………………………………………………$______________
b.
Clergy Support Supplement requested (annualized amount*)………………………….………..$______________
This amount will be divided by 12 and paid monthly for the length of time approved. Mid-year requests will be adjusted
accordingly. Please indicate if your request is for:
□
□
12 months (January – December)
6 months (July – December)
IV.
REMARKS:
a.
Clergy: Please indicate, among other things, how long you anticipate this charge will continue to need salary
supplementation. Be particularly specific if the charge does not provide at least two-thirds of the salary and utilities.
____________________________________________________________________________________
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____________________________________________________________________________________
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What historical / cultural / economic / situational elements affect your ministry and congregation?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
b.
Lay member: Please include a statement addressing your church’s impact on your community and your congregation’s
connection with other cooperative ministries such as community groups, ecumenical organizations, and other United
Methodist churches.
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