This is the contact information form that is filled out by clergy coming to ensure our database records are accurate. Resource Category: FormsClergy Forms Last Name * First Name * Middle Name or Initial * Home Address Street * Home Address City State Zip * Work Address Street If you have a work address you would like to supply, you may enter it here. Otherwise, leave blank. Work Address City State Zip If you have a work address you would like to supply, you may enter it here. Otherwise, leave blank. Billing Address Street If you have a post office box or address other than your home or work that you wish to use for correspondence, enter here. Otherwise, leave blank and the home address will be used for correspondence. Billing Address City State Zip If you have a post office box or address other than your home or work that you wish to use for correspondence, enter here. Otherwise, leave blank and the home address will be used for correspondence. Email address (Primary) * The email address which you want used for correspondence with the diocese. Email address (Work) Optional work email address Phone Number (Home) * Enter phone number in the form 123.123.1234 Phone Number (Mobile) Phone Number (Work) Phone Contact Preference * Home Mobile Work Which number do you prefer as your primary contact number? Headshot If you wish you may supply a headshot for the clergy directory. The photo should be a minimum of 300x300 and no larger than 800 KB.Files must be less than 800 KB.Allowed file types: gif jpg jpeg png. Birthdate * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year1917191819191920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019 Ordination Date - Diaconate * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022 Ordination Date - Priest Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022 Seminary/Other Education * Enter the seminary where you went as well as the graduation date Spouse/Partner Please enter spouse/partner's full name, birth date and anniversary date. Spouse/Partner email Children Please enter each child's full name, birth date and gender Publications * PIE (Bishop's weekly letter) a la Mode (Newsletter for spouses and partners) Stirrings (Stewardship newsletter) Across the Diocese (General email newsletter) Please select the publication options you wish to receive from the diocese. Online Info Please list any personal websites, blogs or social media links that you maintain and post content Dietary Restrictions Please list any food allergies or dietary restrictions Foreign Languages Please list any languages other than your native one in which you are proficient and would be comfortable doing liturgy Training Programs * Safeguarding God's Children Safeguarding God's People Anti-Racism Training Please check those training programs which you have completed.