Congregation Staff Compensation Form

Please include data for all congregation employees except teaching elders, ruling elders commissioned to pastoral service, Certified Christian Educators, and Certified Associate Christian Educators.

IF THE CONGREGATION HAS NO EMPLOYEES in addition to a teaching elder, ruling elder commissioned to pastoral service, Certified Christian Educator, or Certified Associate Christian Educator, PLEASE LIST “NONE” AND SUBMIT FORM

Use the “+” to add additional staff member as needed

Congregation Staff Compensation Form

Name of Congregation*

Staff Compensation Form*

Position Title	Hrs /Wk	Salary	Board of Pensions (Y or N)	403b (Y or N)	Med. Ins. Available (Y or N)	Med. Ins. Taken (Y or N)	Unemploy- ment Ins. (Y or N)	Other Compen -sation? (List type)	Paid Vacation (# of days)	Paid Study Leave (# of days)	Study Leave Reimburse -ment (list amount)	Other Reimburse -ment (list type)