Summary Report Action Outline SRAO05 LP: Reinstatement of License for Pastoral Ministry Name:
______________________________________________________________________ DCOM Registrar
District:
[__] AP [__] CM [__] NR [__] SS [__] SM [__] TV
Note:
On this form you will list all Persons for which a vote is taken and place the date of the vote in the appropriate column.
Local Pastor Last
First
Please submit copies of this form to: [__] DCOM file [__] The Office of Clergy Services via DCOMConcerns@holston.org
Vote: Reinstatement of License for Pastoral Ministry Approved Unapproved Date Date
Updated: 2025-08