Home » Resources » Nominations » Nominations Interest Form Nominations Interest Form Completing this form expresses your interest in serving as a member of a Michigan Conference agency (i.e. board, committee, council, etc.). Thank you for your interest! A member of the Nominations Committee will be in contact for further discernment. Completing this form does not mean you will automatically become a member of a Michigan Conference agency.Name(Required) Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last Suffix Address(Required) 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 Phone(Required)Email(Required) Clergy or Laity? Clergy Laity Please indicate your clergy status. If you're a retired Local Pastor under appointment, select "Appointed Local Pastor"Ordained Deacon/ElderRetired Elder/Deacon/Associate MemberProvisional Deacon/ElderAppointed Local PastorAssociate MemberOrdained from other Christian denomination (OF)Provisional or Ordained member from other Annual Conference (OE or OP)Affiliate MemberRetired Local Pastor (with M.Div. or completed COS) not under appointmentWhat congregation is your membership located? DistrictSelect DistrictCentral Bay DistrictEast Winds DistrictGreater Detroit DistrictGreater Southwest DistrictHeritage DistrictNorthern Skies DistrictWestern Waters DistrictOtherSelect the district. If you are unsure of your district, please contact your local church.We have a deep commitment to inclusiveness regarding age, gender/gender identity, race/ethnicity, and sexual orientation. Providing the following information will help achieve our goals of representational balance in agency membership. Please feel free to answer the questions as you are comfortable and in ways that are most descriptive of how you self-identity.Age: Gender/Gender Identity: Race/Ethnicity: Sexual Orientation: Please take a moment to answer the questions below. Your responses will help the Nomination Committee discern the best fit between your interests, skills, and gifts and open leadership positions.I am interested in serving on this Conference Agency (if applicable):Leadership roles you have held in your Local Church, District, and/or Conference:Why do you want to serve?What education, skills, experience, and/or perspectives do you bring?After you complete the form click SUBMIT. The Nominations Committee thanks you for your help. Last Updated on August 7, 2023