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Circuit Elder Contact Report
Contact Information
NOTE: For mentoring reports, please DO NOT use this circuit elder form. Instead, please use the BOM/dCOM's Mentor report form AR080:
http://arumc.wufoo.com/forms/ar080/
Circuit Elder Name
*
Circuit Elder Email Address
*
Type of Contact
*
Circuit Meeting
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)
Other
Other
Date of Meeting/Contact
*
+
District
*
🛈
Central (CE)
Northeast (NE)
Northwest (NW)
Southeast (SE)
Southwest (SW)
Name of Church/Charge (if not a circuit-wide meeting)
Name of Pastor (if not a circuit-wide contact/meeting)
Contact Report
1) Describe the Contact
*
2) What next steps are the pastor/congregation going to take?
3) What does the District Superintendent need to know?
Consultation Response
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
CALL
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.