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TE Ministry/Status Change Form

This form is designed to update a Teaching Elder’s status or other information pertaining to his or her ministry. Items marked with a red star are required. Thank you for helping us keep our records up to date. For assistance or more information, contact the Office of the Assistant Stated Clerk at 407-930-4239 or zenaida.bermudez@epc.org.

"*" indicates required fields

Minister's Name*
Minister's Home Address*
Phone Type*

Complete the sections pertinent to status changes on the above-named minister.
Received Date

Is the TE staying in the presbytery that is receiving him/her?*

Dismissal Date
Dismissal from Other Denomination is Pending
Specify Position (Pastor, Chaplain, etc.) and Church or Institution Name.

Minister's New Place of Ministry

Effective Date*
Address*

Change In Status

Newly Ordained*
If Yes, Date of Ordination
If Yes, Date of Installation

Retired?*
If Yes, Effective Date
If Yes, Service of Recognition Date
Deceased?*
If Yes, Date of Death
Associate Member?*
Moved to Inactive Status?*
Moved to Inactive Status at Minister's Request?*
If Yes, Effective Date
Censured (Book of Discipline)?*
If Yes, Date of Censure
Removed from Office without Sanction (Book of Government 14-4)?*

Signature

Please provide the name and email address of the individual completing this form.
Name*
Today's Date*
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