Circuit Elder Contact Report
NOTE: For mentoring reports, please DO NOT use this circuit elder form. Instead, please use the BOM/dCOM's Mentor report form AR080:
Circuit Elder Name
Circuit Elder Email Address
Type of Contact
Fall Leadership Gathering
Charge Conference with Congregation
Contact with a Pastor
Contact with a Church Leader (please identify leader in the report's Question 1 below)
Date of Meeting/Contact
Name of Church/Charge (if not a circuit-wide meeting)
Name of Pastor (if not a circuit-wide contact/meeting)
1) Describe the Contact
2) What next steps are the pastor/congregation going to take?
3) What does the District Superintendent need to know?
Follow Up Plan:
No follow-up needed
I will be following up with the Pastor
I need a call from the DS about the situation
NOTE: In situations of concern, please complete this form and then immediately
your district superintendent.
Once you click "submit," your Circuit Elder Contact Report will be
emailed to the District Office, with a receipt emailed to you.