LAY SERVANT’S ANNUAL REPORT
UPPER NEW YORK CONFERENCE/THE UNITED METHODIST CHURCH
REPORT OF THE LAY SERVANT TO THE CHARGE CONFERENCE
Initial Application or Request for Renewal
This report covers the 12-month period from ______to ______, 20__
(either January-December or from last to current charge conference)
(PLEASE PRINT OR TYPE)
PART 1. DATA ON THE LAY SERVANT
Name ______Mr. Mrs. Ms. Name of District ______
What name do you go by (i.e. Sue, Bob, Jim)? ______Name of Church ______
Address ______Church Address ______
City/State/Zip ______City/State/Zip ______
Home Telephone ______Work Telephone ______Church Telephone ______
Cell Phone ______Email Address ______
PART 2. STATUS OF THE LAY SERVANT
I am applying to BEGIN as a: I am applying for RENEWAL as a:
local church lay servant or certified lay servant local lay servant or certified lay servant
I have completed the Basic Lay Servant course date_____ Date of the latest advanced or refresher course I took: ______
I have completed my first advanced course date_____ The Name of the LAST advanced or refresher course I took:
The name of the course ______
(Please complete the other side of this form.)
______
PART 3. REQUEST OF THE LAY SERVANT
I hereby request recommendation of my pastor and my charge conference to begin or renew as a local church lay servant or
certified lay servant for the ensuing year.
______
(Date)(Signed – Lay Servant)
______
PART 4. RECOMMENDATION OF THE PASTOR
I recommend concurrence with the request of this lay servant to begin or renew as a local church lay servant or
certified lay servant for the ensuing year.
______
(Date)(Signed – Pastor)
______
PART 5. CHARGE CONFERENCE RECOMMENDATION
The charge conference of the ______(church or charge) recommends that the above lay servant begin or renew as a local church lay servant or certified lay servant for the ensuing year.
______
(Date)(Signed – District Superintendent)
______
PART 6. ACTION BY THE DISTRICT COMMITTEE ON LAY SERVANT MINISTRIES
This application to begin or be renewed as a local church lay servant or certified lay servant within the Genesee Valley District of the Upper New York Conference is approved disapproved for the ensuing year.
______
(Date)(Signed – Chair, District Committee on Lay Servant Ministries)
LAY SERVANT’S ANNUAL REPORT(Continued)
PART 7. MINISTRIES BY THE LAY SERVANT
During the past year I have participated in these ministry opportunities:
served as MEMBER of committee, board commission, council, task force:
at my local church (what) ______
beyond my local church:
in my district (what) ______
in my conference (what) ______
in my jurisdiction (what) ______
at the general church level (what) ______
served as CHAIR of committee, boards, task force (what) ______
served as a volunteer at a community agency (what) ______
served as a volunteer in a caregiving institution (what) ______
provided one-on-one caring:
at a hospital, at a nursing home, or to a shut-in
in membership/evangelism visitation
other: ______
provided leadership in caring/outreach projects (such as a food pantry, prison ministry, Society of St.Stephen) (what) ____
______
taught classes (what, how many) ______
served as a worship leader in services (how many) ______
delivered devotional messages (where, how many) ______
preached in worship services (where, how many) ______
Additional opportunities for leading, caring, and communicating ministries participated in by the lay servant (describe opportunity and your part in it): ______
______
PART 8. PERSONAL AND SPIRITUAL GROWTH BY THE LAY SERVANT
In what activities have you engaged and/or what books have you read and used during the past year to help you develop your devotional life; improve your understanding of the Bible; improve your understanding of The United Methodist Church; and improve your skills in leading, caring, and communicating?
______
______
______
PART 9: FEEDBACK BY THE LAY SERVANT
Do you believe that you have had adequate opportunity for service as a lay servant this past year? yes no
(If no, please explain) ______
What additional training or support do you need? ______
______
______
Give any recommendations you have for improving the Lay Servant Ministries in your district or annual conference: ______
______
______
______
When Parts 1, 2, 3, 4, 5, 7, 8, and 9 have been completed, please make a copy for yourself and forward the original to:
for the Committee’s action.