SFD Delegate Certificate of Election for NDI 4 Jan 26

Certificate of Election Delegates to NDI Convention
District Assembly and Conventions 2026
Southern Florida District Church of the Nazarene
April 9-11, 2026
Lake Placid Camp and Conference Center
2665 Placid View Dr., Lake Placid, FL 33852

Information Due: February 28, 2026

Voting at District Assembly and Conventions
All voting at District Assembly and Conventions 2026 will be online.
All Reports are online only.
All Delegates will receive information by text and email for voting at District Assembly and Conventions 2026.
We will use information in this form; to give delegates and others access to vote at District Assembly and Conventions.
Unable to accept any paper reports for District Assembly and Conventions.
Local Church
Local Church*
Other Church
Ex-Officio Delegate
Lead Pastor
Lead Pastor

First NameLast Name
Lead Email
example@example.com
Lead Cell Phone Number
Please enter a valid phone number.
Add Co-Pastor Information

YesNo
Co-Lead Pastor

First NameLast Name
Co-Lead Pastor Email
example@example.com
Co-Lead Pastor Cell Phone Number
Please enter a valid phone number.
Board Secretary Name

First NameLast Name
Board Secretary Email
example@example.com
Board Secretary Phone Number
Please enter a valid phone number.
NMI President
NMI President Name

First NameLast Name
NMI President Email
example@example.com
NMI President Cell Phone Number
Please enter a valid phone number.
NDI Chair
NDI Chair Name

First NameLast Name
NDI Chairt Email
example@example.com
NDI Chair Cell Phone Number
Please enter a valid phone number.
NYI President
NYI President Name

First NameLast Name
NYI President Email
example@example.com
NYI President Cell Phone Number
Please enter a valid phone number.
Elected Delegates NDI Convention
NDI Delegate #1
Delegate #1

First NameLast Name
Delegate #1 Email
example@example.com
Delegate #1 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Delegate #2
Delegate #2

First NameLast Name
Delegate #2 Email
example@example.com
Delegate #2 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Delegate #3
Delegate #3

First NameLast Name
Delegate #3 Email
example@example.com
Delegate #3 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Delegate #4
Delegate #4

First NameLast Name
Delegate #4 Email
example@example.com
Delegate #4 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Delegate #5
Delegate #5

First NameLast Name
Delegate #5 Email
example@example.com
Delegate #5 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Delegate #6
Delegate #6

First NameLast Name
Delegate #6 Email
example@example.com
Delegate #6 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Delegate #7
Delegate #7

First NameLast Name
Delegate #7 Email
example@example.com
Delegate #7 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Delegate #8
Delegate #8

First NameLast Name
Delegate #8 Email
example@example.com
Delegate #8 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Delegate #9
Delegate #9

First NameLast Name
Delegate #9 Email
example@example.com
Delegate #9 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Delegate #10
Delegate #10

First NameLast Name
Delegate #10 Email
example@example.com
Delegate #10 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Delegate #11
Delegate #11

First NameLast Name
Delegate #11 Email
example@example.com
Delegate #11 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Delegate #12
Delegate #12

First NameLast Name
Delegate #12 Email
example@example.com
Delegate #12 Cell Phone Number
Please enter a valid phone number.
Alternates Delegates to NDI Convention
NDI Alternates Delegate #1
Alternates Delegate #1

First NameLast Name
Alternates Delegate #1 Email
example@example.com
Alternates Delegate #1 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Alternates Delegate #2
Alternates Delegate #2

First NameLast Name
Alternates Delegate #2 Email
example@example.com
Alternates Delegate #2 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Alternates Delegate #3
Alternates Delegate #3

First NameLast Name
Alternates Delegate #3 Email
example@example.com
Alternates Delegate #3 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Alternates Delegate #4
Alternates Delegate #4

First NameLast Name
Alternates Delegate #4 Email
example@example.com
Alternates Delegate #4 Cell Phone Number
Please enter a valid phone number.
Add Another Delegate

YesNo
NDI Alternates Delegate #5
Alternates Delegate #5

First NameLast Name
Alternates Delegate #5 Email
example@example.com
Alternates Delegate #5 Cell Phone Number
Please enter a valid phone number.
Submitter Info
Date

MonthDayYear
Date
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Signature

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Certificate of Election Delegates to NDI Convention

Local Church

Ex-Officio Delegate

Lead Pastor

NMI President

NDI Chair

NYI President

Elected Delegates NDI Convention

NDI Delegate #1

NDI Delegate #2

NDI Delegate #3

NDI Delegate #4

NDI Delegate #5

NDI Delegate #6

NDI Delegate #7

NDI Delegate #8

NDI Delegate #9

NDI Delegate #10

NDI Delegate #11

NDI Delegate #12

Alternates Delegates to NDI Convention

NDI Alternates Delegate #1

NDI Alternates Delegate #2

NDI Alternates Delegate #3

NDI Alternates Delegate #4

NDI Alternates Delegate #5

Submitter Info