GA NYI Convention Delegate Registration Form

District NYI Convention

Camp Adrian TabernacleJune 2nd, 202510:00 AMLunch will be available after the convention. Register for lunch at the bottom.
Church Name
NYI Charter - District Ministry Plan IV, Section 3 - District NYI Convention:

All local NYI delegates to the District NYI Convention must be members of the Church of the Nazarene that they represent.

The number of local NYI delegates for each church is determined by the membership figures on the most recent local Pastor's Report prior to the District Assembly.

The local NYI delegation to the District NYI Convention for churches consists of:
- The pastor and youth pastor or any full-time paid pastoral staff who participate in NYI ministry;
- The local NYI President;
- Up to four elected delegates, with at least half being within the district-established NYI ministry focus
Local churches may add an additional delegate for each successive 30 local NYI members and/or final major part of those 30 members.
- EX: Number of NYI Members / Number of delegates
- 5-45 / 4
- 46-75 /5
- 76-105 / 6
- 106-135 / 7
- 136-165 / 8
- 166-195 / 9
* Number of delegates from a local NYI does not include ex officio delegates (Local NYI President, pastor, youth pastor, District NYI Council members from a local church
City
Lead Pastor
Email
example@example.com
Our official delegates to the District NYI Convention and voting will be:
Lead Pastor
Youth Pastor
Name

First NameLast Name
NYI President
Name

First NameLast Name
Full time Salary Associate (if any)
Name

First NameLast Name
Delegate Name
Age Range
Delegate Name
Age Range
Delegate Name
Age Range
Delegate Name
Age Range
Delegate Name
Age Range
Delegate Name
Age Range
Signature of Pastor / Youth Pastor
Date

MonthDayYear
Date
(to be completed by the Pastor or NYI President)
Church Name
Pastor
NYI President
** Very Important ** Please fill this out too!

Lunch will be available on the campground after the convention, but we must have a count for preparation.
The cost will be $12 per person.

A lunch wristband will be given for those that pay for lunch at convention sign in and given out at that time.
(Sign in will begin at 9AM on June 2nd)
Please make checks payable to GA NYI for lunch or cash is acceptable
YesNo
If so how many?
Should be Empty:

District NYI Convention