2019 - Annual Report of the Pastor in an Appointment to an Extension Ministry

Please fill out the form below based on 2019 information. To save your form, click Save at the bottom of this page, which will return you to your forms dashboard. The dashboard shows your progress and allows you to return to the form if you have not finished filling out all the information. Once you are completely finished, click Save at the bottom of this page to return to the forms dashboard, and then fill in your name and click Officially Submit My Forms.  We will not receive your form until you do this!  


*First Name
*Last Name
Preferred Name
*Home - Street address, City, State, Zip
*Evening phone

If you use your cell phone as your evening phone, this will be listed as your evening phone in the Directory.

Cell Phone

This will not be published in the Directory; we will add it to our internal database and use it when necessary.

*Business - Street address, City, State, Zip
*Daytime phone

If you use your cell phone as your daytime phone, this will be listed as your daytime phone in the Directory.

*Preferred address for mailing and directory listing purposes
*NYAC Membership Type
*Charge Conference Membership - Church

Please choose your church from the drop-down list (sorted by physical city/town, then church name):

*Your Appointment Category (per para. 344 in the 2016 Discipline)
*Agency/Institution Name
*Your Job Title or Position
*Service Time
1/4 time
1/2 time
3/4 time
Full time

Please let us know what percentage of time you work in this position.

*Initial Start Date of this Position

This is the date when you began this particular position; NOT the date when you began serving in any AIEM appointment.

*2019 Base Compensation for the Year (dollar amount)

This is the total amount you earned in 2019 for this position.

*Travel Allowance (dollar amount)
*Parsonage/home provided
*Or, Housing Allowance (dollar amount)

For more information on housing allowances, please see Ross Williams' blog post on this topic: https://www.nyac.com/blogdetail/12667236

*Other Cash Allowances (dollar amount)
*I have completed Anti-Racism Training, a requirement for all NYAC Clergy
Date completed
*I have completed Boundaries Training, a requirement for all NYAC clergy
Date completed
*Does the institution where you serve evaluate your work?
*Please provide a narrative reflecting your ministry

This field will expand for you, however, if your narrative is too long, please send it via email to Robert.Knebel@nyac-umc.com. You will also need to send this narrative to your NYAC charge conference pastor - this will not happen automatically by submission of this form. 

In addition, please send evidence of your continuing education and spiritual growth program and future plans (per ¶ 344.2) to Robert.Knebel@nyac-umc.com.

For those under appointment outside of the NYAC, complete the following:
Conference where you serve
Affiliate charge conference membership
District Superintendent
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