LAY Delegate Credentialing
This form is for the registering of a voting and alternate voting lay delegate for your congregation. Please submit one form for Voting Delegate and one form for Alternate Voting Delegate (a total of TWO forms per congregation).
Type of Delegate
*
Voting Delegate
Alternate Voting Delegate
Delegate Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Congregation Information
Congregation Name
*
Congregation City & State
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Relevant Experience
Relevant Experience is optional but may aid the Convention Committee in solicitation of Floor Committee members
Previous Experience as a Convention Delegate, if applicable (list years and/or committees)
Congregation/District/Synod Experience (i.e. Boards, Committees) (include years)
Political/Civic Experience (i.e. Elected Office, Clubs) (include years)
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Delegate Credentialling
Please list the name, email addresses, and roles of two Congregational Officers who can verify that the above name has been duly selected to represent the congregation as a voting delegate and is member in good standing of your congregation. One Congregational Officer can be your pastor. If you have a multi-pastor staff, please list the Senior Pastor.
Congregational Officer 1
*
First Name
Last Name
Email 1
*
example@example.com
Congregational Officer's role
*
i.e. Pastor, President, Secretary, Head Elder, etc.
Congregational Officer 2
*
First Name
Last Name
Email 2
*
example@example.com
Congregational Officer's role
*
i.e. Pastor, President, Secretary, Head Elder, etc.
Submit
Should be Empty: