2022 FSLDW Pastoral Charge Information Form

Name of Pastoral Charge or Community of Faith (if a one-point charge)*

Name of Other Ministry*

Mailing Address*

Street Address Address Line 2 City Province Postal Code

Phone #*

Email Address*

Pastoral Charge Website

Minister

First Last

Minister's Email Address

List the Points on your Charge:

Name of person submitting this form*

First Last

Email for person submitting this form*

A copy of the submitted form will be emailed to you.

Board/Council Chair (or equivalent)

Name (Board/Council Chair or equivalent)

First Last

Phone

Address

Street Address Address Line 2 City Province Postal Code

Email

Board/Council Secretary

Name (Board/Council Secretary)

First Last

Phone

Address

Street Address Address Line 2 City Province Postal Code

Email

Pastoral Charge/Office Manager (if applicable)

Name (Pastoral Charge/Office Manager if applicable)

First Last

Email

Phone

Treasurer

Name (Treasurer)

First Last

Phone

Address

Street Address Address Line 2 City Province Postal Code

Email

Trustees Chair

Name (Trustees Chair)

First Last

Phone

Email

M&P Chair

Name (M&P Chair)

First Last

Phone

Email

Justice, Mission and Outreach

The person whose role is to disseminate information and education, as well as work with the Pastoral Charge Outreach Committee or equivalent to plan initiatives for the local Pastoral Charge.

Name (Justice, Mission and Outreach)

First Last

Phone

Email

Cemetery Contact Person

For points which no longer have a congregation.

Name (Cemetery Contact Person)

First Last

Phone

Email

Children, Youth and Young Adult Leader

If you have someone in your congregation who is working with youth and/or young adults please let us know as our Minister for Children, Youth and Young Adults and the Faith Formation Team would want this information to help build connections for youth and children. If you do not have children or youth, please give us the name of your Christian Development Committee or someone to connect with regarding bible study, faith formation, etc.

Name (Children, Youth and Young Adult Leader)

First Last

Phone

Email

Sunday School (Children's Programs) Leader

Name (Sunday School (Children's Programs) Leader)

First Last

Phone

Email

Local UCW or Women's Group Representative

Name (Local UCW or Women's Group Representative)

First Last

Phone

Email

Local Men's Ministry Group Representative

Name (Local Men's Ministry Group Representative)

First Last

Phone

Email

Stewardship

Name (Stewardship)

First Last

Phone

Email

Mission & Service

Mission & Service Enthusiast/Stewardship Point Person may be the same person. The role is to be a liaison between the stewardship team and the Pastoral Charge for matters and education regarding stewardship and Mission & Service.

Name (Mission & Service)

First Last

Phone

Email

“The use, retention and disclosure of personal information collected from this form is done in compliance with privacy legislation including, but not limited to, the Personal Information Protection and Electronic Documents Act (2000, c.5).”

2022 FSLDW Pastoral Charge Information Form

Board/Council Chair (or equivalent)

Board/Council Secretary

Pastoral Charge/Office Manager (if applicable)

Treasurer

Trustees Chair

M&P Chair

Justice, Mission and Outreach

Cemetery Contact Person

Children, Youth and Young Adult Leader

Sunday School (Children's Programs) Leader

Local UCW or Women's Group Representative

Local Men's Ministry Group Representative

Stewardship

Mission & Service

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