• Interim Pastor Assignment

    Please return this form 1 month prior to your departure.
  • Type of travel*
  • Date leaving
     - -
  • Scheduled arrival
     - -

  • Ministry address
    Church name:      
    Church mailing address:      
    Church location address:       
    Church phone:    
    Church email:        

  • Your contact information while at ministry
    Address:
    Phone:
    Email:      

  • Church remuneration:
          

  • Emergency contact person in the church
    Name:
    Address:
    Phone:      
    Email:      

  • Personal emergency contact (other than your spouse)
    Name:
    Address:
    Phone:      
    Email:      

  • Contact information upon return from this ministry
    Address:
    Phone:
    Email:      

  • Was the church able to install a new pastor?         
    If yes, please give the new pastor's full name:  

    Our future assignment is uncertain at this time.          
    If no, what is your next assignment?      

  • Financial arrangements for
          
    Bank:
    Account number: 
    Routing number:        
    Other:      

  • Until you click the submit button, we cannot access your information.

  • Should be Empty: