Clergy Info Update Form

Please use this form to update your records for contact information.

Note: This form is not a replacement for appropriate clergy licensure, which can be accessed here.

(* Denotes Required Fields)

Name and Family
Title: *	The Rev. The Rev. Deacon The Rev. Dr. The Very Rev. The Very Rev. Dr. The Rt. Rev. The Most Rev. The Rev. Canon
First Name: *
Middle Name/Initial:
Last Name: *
Suffix:
Date of Birth:
Name Preferred to be Called:
Preferred Form of Address: *	Father Mother Mr. Ms. Mrs. Dr. Dean Deacon Rev.
Spouse Title:
Spouse First Name:
Spouse Middle Initial/Name:
Spouse Last Name:
Spouse Suffix:
Position
Status: *	Employed full time Employed part time Retired In Search/Other
Church Name and Location (of employment):
Church Name and Location (of attendance):
Title:
Title Examples: Rector; Priest-in-Charge; Interim Rector; Associate for Youth & Family Ministries
Position Start Date (or Expected Start Date):
Contact Information
Home Phone:
Business Phone:
Cell Phone:
Preferred Phone:	Home Business Cell
Personal e-Mail Address:
Business e-Mail Address:
Preferred e-Mail Address:	Personal Business
Address 1
Address 1 - Type:	Home Business/Organization
Physical and/or Mailing? :	Physical Mailing
Address 1 Line 1 (Street Address, Apartment):
Address 1 Line 2 (City, State, Zip):
Address 2
Address 2 - Type:	Home Business/Organization
Physical and/or Mailing?:	Physical Mailing
Address 2 Line 1 (Street Address, Apartment):
Address 2 Line 2 (City, State, Zip):
Communications
Please indicate your status/preferences below.
It's most helpful for clergy to receive all three of the communications below to stay up-to-date! Folks new to the Diocese are added to mailing lists by completing this form, so your answer will most likely be "No, but I would like to subscribe."
I receive the e-Communique bi-weekly newsletter via e-mail.: *	Yes No, but I would like to subscribe. No, and I would not like to subscribe. I'm not sure, please check my status.
I receive the Clergy Communique monthly newsletter via e-mail.: *	Yes. No, but I would like to subscribe. No, and I would not like to subscribe. I'm not sure, please check my status.
Comments
Please provide us with any other pertinent information.: