Southeastern Synod Respite & Renewal Grant Application (R&R1)

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Each Rostered Leader who wishes to obtain financial support for a sabbath respite and renewal time away must complete the following grant application and submit this form to the R&R Grant Review Team. Applications will be reviewed quarterly.

Applications must be time stamped by March 1, June 1, September 1, or December 1, for consideration during each respective quarter. Thank you for making your wellness a priority.

If you need help completing this application, please contact Pastor Justin Eller (jeller@elca-ses.org or 404-589-1977 ext. 232).

Email *

+ Contact Information +

Your first and last name(s) *

Your preferred email address *

Congregation name *

Congregation city and state *

Your home address *

Your preferred phone number *

+ Need +

Brief statement of the personal and professional need for this sabbath respite and renewal time away. (Why is this activity or time away important to your well-being, your ministry? How do you expect it to help you sustain your well-being once it is concluded?) *

How will you use the grant for yourself? *

How will you use the grant for your congregation? *

When do you plan to begin your time away? *

YYYY

When do you plan to conclude your time away? *

YYYY

+ Objective +

Your definition/understanding of "wellness or well-being" (how do you define "wellness or well-being"?) *

Which of the following dimension of well-being do you hope to tend to during the sabbath respite and renewal time? *

Social/Interpersonal well-being

Emotional well-being

Physical well-being

Financial well-being

Vocational well-being

Intellectual well-being

Other:

Required

+ Evaluation +

How will your well-being be measured?
*

What are possible indicators of improved well-being from the sabbath respite and renewal time away? *

Who will be your accountably partner/buddy/friend for your improved well-being? *

+ Budget +

Justify each cost category that applies, i.e., equipment, fees, supplies, travel, release time, etc. (Attach documentation of anticipated expenses required.)

Which level of sabbath Respite & Renewal Grant are you applying for? *

Level 1 ($500-$1,000)

Level 2 ($1,000-$2,500)

Level 3 ($2,500-$5,000)

How much of the grant will go to the congregation? and what will it cover? *

Have you contacted a possible supply? And if so, have they agreed? *

How much of the grant will go to you personally? and what will it cover? *

I (the applicant) will provide funds in the amount of *

** Electronic Signature **

By clicking the "I accept" box below, you are signing this Respite & Renewal Grant Application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.
*

I accept.

I do not accept and will mail a signed, printed copy to the Synod Office c/o Pastor Justin Eller as soon as possible. (Mailed applications must be postmarked by the dates indicated at the top of this application.)

Required

Your name (electronic signature)
*

Today's date (of submitting application)
*

YYYY

NOTE: 1) this R&R Grant Application is part of a "living," developing process and may be modified/updated without prior notification; 2) the R&R Grant Review Team will hold in confidence the specific reason(s) for your need to take time away, unless you are at risk of harm to yourself, harm to someone else, or your time away is related to a boundaries violation, which would then require an appropriate response from the Synod Office.

Email supporting or required documents (i.e., additional budget sheets, signed congregational agreement form, sustained well-being plan covenant, etc.) to Pastor Justin Eller (jeller@elca-ses.org), Assistant to the Bishop for Care and Community when you submit this grant application. Thank you and God bless you.

+ + +

A prayer for your wellness journey...

God of mercy and grace, you are my source of healing and wellness who alone can bring calmness and peace: Grant to me, your beloved, an awareness of your presence and a strong confidence in you. In my exhaustion, pain, weariness, confusion, and anxiety, surround me with your care, protect me with your loving embrace, and permit me once more to enjoy health and strength and peace; through Jesus Christ our Savior. Amen.

A copy of your responses will be emailed to the address you provided.

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