SFD In Memory of Deceased Church Members. 4Feb26

In Memory of Deceased Church Members

Please list below all church members deceased since the last District Assembly. This information is NOT for the NMI Memorial Roll.
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
Church Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Add Church Mailing Address

YesNo
Church Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Lead Pastor
Lead Pastor Name

First NameLast Name
Lead Pastor Email
example@example.com
Lead Pastor Cell Phone Number
Please enter a valid phone number.
Lead Pastor Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse's Name

First NameLast Name
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.
Co-Lead Pastor Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Deceased Church Members 2025
Please list below all church members deceased since the last District Assembly. This information is NOT for the NMI Memorial Roll.
Deceased Church Member #1
Deceased Church Member #1

First NameLast Name
Add Another Deceased Church Member

YesNo
Deceased Church Member #2
Deceased Church Member #2

First NameLast Name
Add Another Deceased Church Member

YesNo
Deceased Church Member #3
Deceased Church Member #3

First NameLast Name
Add Another Deceased Church Member

YesNo
Deceased Church Member #4
Deceased Church Member #4

First NameLast Name
Add Another Deceased Church Member

YesNo
Deceased Church Member #5
Deceased Church Member #5

First NameLast Name
Add Another Deceased Church Member

YesNo
Deceased Church Member #6
Deceased Church Member #6

First NameLast Name
Add Another Deceased Church Member

YesNo
Deceased Church Member #7
Deceased Church Member #7

First NameLast Name
Add Another Deceased Church Member

YesNo
Deceased Church Member #8
Deceased Church Member #8

First NameLast Name
Add Another Deceased Church Member

YesNo
Deceased Church Member #9
Deceased Church Member #9

First NameLast Name
Add Another Deceased Church Member

YesNo
Deceased Church Memberf #10
Deceased Church Member #10

First NameLast Name
Submitter Info
Date*

MonthDayYear
Date
Name*

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

Powered by Jotform SignClear
Please verify that you are human*
Should be Empty:

In Memory of Deceased Church Members

Local Church

Lead Pastor

Deceased Church Members 2025

Deceased Church Member #1

Deceased Church Member #2

Deceased Church Member #3

Deceased Church Member #4

Deceased Church Member #5

Deceased Church Member #6

Deceased Church Member #7

Deceased Church Member #8

Deceased Church Member #9

Deceased Church Memberf #10

Submitter Info