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Annual Report to the Bishop of Atlanta

PLEASE NOTE

It is assumed that members of the clergy with license to officiate in the Diocese of Atlanta will be submitting annual reports to the Bishop in whose diocese they are canonically resident, as required by Canon I.6. This additional report should include only official acts performed under license within the Diocese of Atlanta.

Part 1

First Name

Last Name

Mailing Address

Street

City

State

Zip

Preferred Email

Preferred Personal Email

Preferred Work Email

Calculated Field

Preferred Phone Number

Preferred Home Phone

Preferred Mobile Phone

Preferred Work Phone

What is your canonical diocese?

Other

Part 2

During the year stated above, I was (check all that apply):

RetiredPart-TimeFull-Time

During the year stated above, I was (check all that apply):

Assigned to a parish in the Diocese of AtlantaServing as a supply priest/deaconIn church-related employment (chaplain, pastoral care counselor, etc.)

Parish Name (select all that apply, hold down CTRL to select multiple)

Position (select all that apply, hold down CTRL to select multiple)

Please provide a brief summary of your Ecclesiastical Acts last year.

Part 3

Do you wish to renew your license to officiate with the Diocese of Atlanta?

Part 4

Please attach any additional information here.

Should you have any questions or concerns, please contact kbreedlove@episcopalatlanta.org. Thank you, in advance, for your assistance.

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