Form: Clergy Information Form | Episcopal Diocese of Tennessee

Clergy Information Form

First, Middle, and Last Name(Required)

Home Street Address(Required)

City, State, Zip(Required)

Home Phone

Cell Phone

Work Phone

Preferred Email(Required)

Date of Birth(Required)

Church Serving, if applicable

Position Title

Check All that Apply(Required)

Canonically Resident

Licensed to Officiate

Retired

Priest Ordination Date, Place, Bishop(Required)

Available to Supply

Yes

Marital Status

Date Married

Spouse's Name

Spouse Date of Birth

Spouse Email

Spouse Phone Number

Children's Names and Dates of Birth