dCOM Associate/Provisional Member Action Report Form

dCOM Action Report Form

Vote for Recommendation for Associate or Provisional Membership
Registrar's Full Name*

First NameLast Name
Date of Vote*
Phone Number
E-mail*
example@example.com
District*
Candidate's Name*
Total Number of Members Voting*

Number of Votes*

	For	Against	Abstain

dCOM votes to (check all that apply):*

Recommend for Renewal of Certified CandidacyRecommend Renewal of LicenseRecommend for Associate MembershipNot Recommended for Associate MembershipDiscontinue as a Licensed Local PastorRecommended for Provisional ElderRecommended for Provisional DeaconNot Recommended for Provisional Membership
Should be Empty: