PDMT-Legacy of Ministry Online Application – Ministry Council – Ministry Council of the Cumberland Presbyterian Church

PDMT Legacy of Ministry Online Application

PDMT-Legacy of Ministry Application Form

Name of Person Being Recognized(Required)

Address of Person Being Recognized

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Current Presbytery(Required)

Ordination Date (mm/dd/yyyy)

Enter the Name of Ordaining Presbytery, if known

Name and Dates of Churches Served or Other Ministry Settings

Offices Held or Committee/Board Service (Presbytery/Synod/Denomination/Other)

Application Submitted by (Full Name):(Required)

Address of Person Submitting Application

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email of Person Submitting Application(Required)

Phone Number of Person Submitting Application(Required)

Date to be Presented (mm/dd/yyyy)

Where Presentation Will Take Place

Mail Certificate/Cross to (name):(Required)

Address Where Certificate & Cross is to be Mailed:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Ordination/Ordination Anniversary- $150

Ordination/Ordination Anniversary

No Donation

Retirement Recognition - $150

Retirement Recognition

No Donation

Appreciation/Other Recognition

Enter the amount you wish to donate.

Memorial

Enter the amount you wish to donate.

Total

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