Burkett, Marion E.
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Part of Burkett, Marion E.
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- Burkett, Marion E.
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Ministerial Relationship
Annual Conference
SERVICE
RECORD
(For use in Annual Con ferences)
Name
Sex-Male
V
Female_
Last
;Y) arro.<J
Firs t
Date of Birth
Spouse
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irst
Date of Marriage
Social Security Number
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Mon
Month
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Female -~
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Last
AJoA.J"
(Second Marriage )
Month
reh .
:2 3
'Mdnth
Social Security Number
Day
If Deceased
Give Date -:-:---::--- ---::-- - - Month
!ti-
Day
Year
Date of B i r t h : - : - - - - - - - - -
Day
Month
Last
Sex: Male_
Date of Marriage - - - -- - - -- - - -
Year
Day
Middle
First
Day
Date of Birth
Social Security Number
Spouse
Date of Retirement
Female_
Day
If Deceased
Give Date ::-:--:-:---- - = - - -- Month
Day
Year
Year
Children Under 18 Years of Age
Date of Birth
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CAtu'cl, o( t t.e l(. t3. IN CJ,.,.;!.f (old Dtt!':Jtduit~{l.,);, 1-1 tnh . / '
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Quarterly Conference License (U.B. only) Granted by
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(Annual Con!erence)
Date
Granted--::7
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Annual Conference License (U.B.)-or-((5/J CoAJdd.u-f.t~)
Probationer's License (Preacher on Trial [Ev.]) Granted by _ _ __ _
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(Annual Con!erence)
deQH?P
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(SEE OTHER SIDE)
11
st
Year
Day
Au czusf
Month
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Day
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/ year
Date - -- - - - - - -- - - -- Month
D ay
Year
Annual Conference
Membership
Conference
Relationship
Appointment
Organization
Responsible for
P ension
P ayment
Service
To
From
Month
Service Prior
to Ordination
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GENERAL INFORMATION
If your service under appointment was not continuous please describe any such periods givin g precise dates.
Date
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Signature
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