<p> LAY SPEAKER ANNUAL REPORT REQUEST FOR CERTIFICATION/RENEWAL</p><p>DISTRICT OF THE ALABAMA-WEST FLORIDA CONFERENCE</p><p>THIS REPORT IS FOR THE YEAR NAME (include Mrs., Mr., Ms) </p><p>ADDRESS </p><p>City State Zip Code </p><p>HOME PHONE CELL PHONE </p><p>WORK PHONE EMAIL </p><p>NAME OF CHURCH UMC</p><p>REQUEST FOR INITIAL CERTIFICATION (*) or RENEWAL AS A LAY SPEAKER</p><p>(*) CERTIFICATION IS ONLY AFTER ALL 6 COURSES HAVE BEEN TAKEN</p><p>Certification OR Renewal as a Lay Speaker (if RENEWAL continued to second page)</p><p>REQUEST FOR CERTIFICATION</p><p>WHAT YEAR DID YOU COMPLETE YOUR BASIC COURSE? </p><p>WHICH OF THE FOLLOWING REQUIRED COURSES HAVE YOU TAKEN? (Please list INCLUDING the YEAR, LOCATION AND INSTRUCTOR)</p><p>1. Leading Worship 2. Leading Prayer 3. Discover Your Spiritual Gifts 4. Preaching 5. United Methodist Heritage 6. United Methodist Policy </p><p>WHAT OTHER COUSRES HAVE YOU TAKEN? (Please list INCLUDING the YEAR, LOCATION AND INSTRUCTOR)</p><p>RECOMMENDATION OF YOUR PASTOR: I recommend that this candidate be CERTIFIED in the Lay Speaker Ministries Program</p><p>Pastor’s Signature Date: </p><p>THE CHARGE CONFERENCE OF UMC recommends that this candidate be CERTIFIED in the Lay Speaker’s Ministries Program. </p><p>District Superintendent Signature Church Council Chairman Signature Date: Page 2 of 3 REQUEST FOR RENEWAL</p><p>Name </p><p>Church </p><p>LIST LAST ADVANCED COURSE TAKEN</p><p>TITLE </p><p>WHEN? WHERE? </p><p>INSTRUCTOR(S)? </p><p>RECOMMENDATION OF PASTOR: I recommend that this candidate be RENEWED in the Lay Speaker program for the next year.</p><p>Pastor Signature Date </p><p>THE CHARGE CONFERENCE OF UMC recommends that this candidate be renewed for the ensuing year in the Lay Speaker Program. </p><p>District Superintendent Signature Church Council Chairman Signature</p><p>Date: LAY SPEAKER ANNUAL REPORT Page 3 of 3</p><p>I delivered a message (if certified) of times in different churches</p><p>Please list the names of churches below :</p><p>I use my talents in my own church, other churches, my community, and conference in the following ways: </p><p>In what activities, seminars, studies have you engaged and/or books have you read to help you develop your spiritual life, improve your understanding of the Bible, and/or the United Methodist Church, or to improve your skills, or caring, leading, praying and communicating in the last year?</p><p>Please provide any feedback that will help us improve the Lay Speaking Ministry in your District and/or our Conference. What additional training or support do you need and what recommendations do you have for your Lay Speaking Committee?</p><p>Positions held in my: Local Church: District: Conference: Jurisdiction: </p><p>LAY SPEAKERS: THIS REPORT MUST BE TURNED IN TO YOUR PASTOR TO BE INCLUDED IN YOUR CHURCH’S CHARGE CONFERENCE PACKET. PLEASE KEEP A COPY FOR YOUR OWN RECORDS.</p><p>DISTRICT OFFICE: PLEASE FORWARD A COPY OF THIS REPORT TO YOUR DISTRICT LAY SERVANT DIRECTOR. </p><p>ACTION BY THE DISTRICT COMMITTEE ON LAY SPEAKING MINISTRIES</p><p>This request for renewal is hereby: approved disapproved </p><p>Signed: Date: </p><p>District Director or District Committee Chairman of Lay Speaking Ministries </p><p>DISTRICT DIRECTORS: AFTER APPROVAL, PLEASE FORWARD THIS REPORT TO TRACI HERNDON AT THE CONFERENCE OFFICE FOR DATABASE BASE PURPOSES. CCLSM Form 3 July 2014 This form supersedes all previous versions </p>