Active Rostered Minister - Report to the Synod Bishop, Southeastern Iowa Synod - 2024
This form is for active ministers of Word and Sacrament & Word and Service serving Under Congregation or Synod Council Call. 

If you are retired, on leave, or disability please fill out the Retired, On Leave, Disability Form instead.

You cannot save a partially complete form, please try to complete this form all at one time. It may be helpful to read the form, to know which documentation you need before you begin filling out the form.

Please complete this form as soon as possible. Responses to demographic information (address, roster status etc) are shared with the synod database. All other responses remain confidential between you and Bishop Amy Current. If you would like a copy of your report, please email Bishop Current, current@seiasynod.org and she will send you a copy.

If you would like a printed copy or a PDF version of this form, please contact Val Harlynn, communications@seiasynod.org
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Adresse e-mail *
Date *
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First Name *
Last Name *
What are your personal pronouns?
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Preferred Email Address *
Confirm Email Address *
Home Mailing Address (including City, State and Zip) *
Work Mailing Address (including City, State and Zip) *
Preferred mailing address
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Phone Number *
Full Name of Spouse
Date of Marriage
JJ
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MM
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Emergency Contact: Name
Emergency Contact: Phone
Emergency Contact: Relationship to you
Dependents: Please list full name, relationship and date of birth
Roster Designation *
My status is *
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