First Name:  * Last Name:  * Address:  * City:  * State:  * Zip Code:  * Phone Number  * Email Address:  * Local Church Membership  * Ministerial Status Ordained ElderOrdained DeaconLicensed Minister Indicate your approved ministerial role for the coming year (for classifying you correctly in the District Minutes): Pastoral Service - Full-timePastoral Service - Part-timeGeneral Church AssignmentInterdenominational/Special ServiceChaplainDistrict AssignmentUnassignedMissionaryEducationStudentChristian Education MinisterOther (please indicate below) Please fill out if role code is not indicated above. Times Preached  * Calls Made  * In what ways have you supported the Church of the Nazarene? Please initial below to verify all information is correct Initials  * Once you sumbit your form you will be taken back to the District Secretary Home Page Do not enter anything in this field:

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