Certified Lay Minister Application Virginia Conference

Full Name: ______Attach Form 102 Biographical Form Email: ______SCSO Background Check ______Kroll Expanded Background Check ______

Church Membership: ______United Methodist Church

Certified as a Lay Speaking Minister by ______United Methodist Church Council or Charge Conference on ______(date).

Reasons for application - ______

Local church service demonstrating your appreciation of the history, polity, doctrine, worship and liturgy of the United Methodist Church ______

Lay Speaking Course(s) completed: ______

I hereby request approval as a Certified Lay Minister (The Book of Discipline2004, ¶271)

Signed: ______Date: ______Applicant

Recommendation of the Pastor and the Vote of the Church Council or Charge Conference

Signed: ______Date: ______Pastor

Recommendation of the District Superintendent

Signed: ______Date: ______District Superintendent

Approval of the District Committee on Ordained Ministry

Signed: ______Date: ______Chair of District Committee on Ordained Ministry Form: Sept. 2007