Annual Rostered / Authorized Leader Report Rostered / Authorized Leader Report Annual report to the Bishop What is your current status?Under Call / ContractNot Under Call / ContractOn Leave / DisabilityRetiredDo you wish to discuss the possibility of a change of call? No Yes Is your request urgent? Yes No Title / RoleThe Rev.The Rev. Dr.DeaconDeaconessSAWLDiaconal MinisterOtherName* First Last Has your contact information changed in the past year?* No Yes Date of Retirement (if began in the last year) MM slash DD slash YYYY Home PhoneCell PhonePreferred Email* This email address is:PersonalWorkOtherMailing Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Have you had a significant change in your life in the past year?Examples: You got married, you got divorced, you had a baby, you adopted a childLife and MinistryName and Location of congregation / ministry site of which you serve / are a member:*Please note any concerns / issues you desire to share with your bishop.As you reflect upon the past year, what were the most significant developments, events, and accomplishments in your life and/or ministry?What challenges do you face now that you are retired?Additional comments:Continuing EducationThe ELCA strongly encourages all rostered ministers and authorized leaders to participate in Healthy Boundaries training at least once every three years and Anti-Racism training at least once every four years.Did you attend Healthy Boundaries training in the past year?* Yes No Did you attend Anti-Racism training in the past year?* Yes No In the past year, you attended... Other continuing education and/or synodical events (list below) No continuing education or synodical events What additional continuing education / synodical events did you attend?*What was your greatest learning / take-away from that education?*Additional comments:Compensation and BenefitsThis personal information is not shared but used to help synod staff be aware of actual compensation patterns in the synod.Your call is: Full time Part time Last year's Defined Compensation (salary and housing)Last year's "Other Benefits" (Continuing Education, Car Allowance, Vacation Time, etc)Last year's Base Salary:Last year's Housing allowance (above base salary)If not provided, just type in the number 0.Other Compensation / Reimbursements for the past yearLast year's Continuing Education allowanceLast year's ELCA Portico Benefits - Pension: 10% 11% 12% Last year's ELCA Portico Benefits - Medical and Dental: Member Spouse Dependents Coverage Waived (Check all that apply)Last year's ELCA Portico Benefits Level: Silver Gold Platinum Δ