2021 Local Church Leaders

2021 Church Leaders

Registration
Person Completing Form

First Name Last Name
Email
example@example.com
Church Name

Street Address Line 2
Local Board of Administration
Vice Chair

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
Church Treasurer / Business Manager

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
LBA Secretary

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
SS Superintendent / Spiritual Formation Director

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
LBA Member At Large

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
LBA Member At Large

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
LBA Member At Large

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
LBA Member At Large

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
LBA Member At Large

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
LBA Member At Large

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
LBA Member At Large

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
LBA Member At Large

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
LBA Member At Large

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
LBA Member At Large

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
Non-LBA Leaders
Youth Pastor / Director

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
Children's Ministry Pastor / Director

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
Wesleyan Men Director / Leader

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
Wesleyan Women Director / Leader

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
Senior Adult Ministry Director / Leader

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
Worship Leader / Music Director

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
Young Adult Director / Leader

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
Lay Leader

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
Other Position: Please add name of position here: blank
Name of person

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number
This is a fill in the Please add name of position here blank
Name of person

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number

Area Code Phone Number

Conference Delegate Registration
Delegate(s)
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Alternate Delegate(s)
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name

HONOR ROLL OF DECEASED LOCAL CHURCH MEMBERS
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
Should be Empty:

Local Board of Administration

Non-LBA Leaders

Conference Delegate Registration

Delegate(s)

Alternate Delegate(s)

HONOR ROLL OF DECEASED LOCAL CHURCH MEMBERS