2025 Certificate of Election

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Local Church*

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Role

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	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

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Role

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	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

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	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

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	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

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	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

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	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

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Name

First NameLast Name

Email

example@example.com

Role

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	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Do you have more delegates to register?*

YesNo

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Name

First NameLast Name

Email

example@example.com

Role

Choose all that apply:

	Delegate	Alternate
District Assembly
NDI Convention
NMI Convention
NYI Convention

Certificate of Election

DELEGATE INFORMATION