Church Certificate of Election

Certificate of Election

{yearReporting}

Delegates to the District Assembly
Year Reporting
Church Name From Sheet
Church Name*
District*
Year-End Church Membership Number*
Assembly Date*

MonthDayYear
Date

Ex Officio Delegates
(Members of the district assembly by virtue of office for the new assembly year) According to Manual 201, department heads (or their Vice) elected to serve in the new church year represent your church at the District Assembly, not the officers during the past year.
NMI President*
NMI President Email*
example@example.com
NMI Vice President
NMI Vice President Email
example@example.com
NYI President*
NYI President Email*
example@example.com
NYI Vice President
NYI Vice President Email
example@example.com
NDI Superintendent*
NDI Superintendent Email*
example@example.com
NDI Vice Superintendent
NDI Vice Superintendent Email
example@example.com

Church Board Secretary*
Date*

MonthDayYear
Date
Church Board Secretary Email*
example@example.com
Pastor*
Date*

MonthDayYear
Date
Pastor Email*
example@example.com
Church Board Secretary: This form is your acknowledgemnt of the offical delegates and alternates for your local church. When you click "Submit", It is considered your offical signature via electronically. This will be emailed automatically to the District Secretary.

District Assembly Certificate of Election, Rev. 14-Mar-18
Should be Empty:

Certificate of Election