Youth Delegate Nomination Form

SYNOD 2026

Diocese of the Mid-Atlantic
NOVEMBER 12 - 14, 2026
TRURO ANGLICAN CHURCH
FAIRFAX, VA
Candidate Nomination Form for Youth Delegate to Synod
Youth Delegates to Diocesan Synod: Four at-large Youth Delegates, ages 16-22, drawn from eligible voters of four different Congregations and Missions of the Diocese will be appointed by the Standing Committee to serve for one year (Constitution, Article IV, Sec. 2E and Canons Title IA, Canon 2, Sec. 3 C).

Youth delegates have voice and vote. Applications are due by October 1, 2026.

You will receive by email a PDF copy of this completed form. If you are unable to have the additional signatures signed before submitting, use the PDF you receive to complete the remaining signatures.

The signed questionnaire can then be scanned, emailed, or mailed to Lisa Anderson, Registrar, registrar@anglicandoma.org, or Diocese of the Mid-Atlantic 14851 Gideon Dr. Woodbridge, VA 22192.
Full Name:*
First & Last
Mailing Address:*
Street Address, City, State, Zip
E-Mail Address:*
example@example.com
Preferred Phone:*
Format: (000) 000-0000.
Your Church Name:*
Date of birth (MMDDYY):*

MonthDayYear
Date
If you are 16-18 years old, are you or your parents members of your church OR if you are 19-22 years old, have you been confirmed or received by a Bishop of the Province or another province of the Anglican Communion?*

Yes
I affirm the Declarations of the Province and the Jerusalem Declaration.*

Yes
Read the Declarations of the Province and the Jerusalem Declaration.
I am applying for:*

Youth Delegate to Synod
Please provide a short summary of your involvement at your church:*
In a few sentences tell why you are interested in serving at this Synod:*
Endorsement of Nomination:
Rector's/Vicar's Signature
Senior Warden's Signature
Should be Empty:

SYNOD 2026

Candidate Nomination Form for Youth Delegate to Synod