Candidate Nomination Form

SYNOD 2026

Diocese of the Mid-Atlantic
NOVEMBER 12 - 14, 2026
TRURO ANGLICAN CURCH
FAIRFAX, VA
Candidate Nomination Form for Diocesan Positions
Once you have submitted this application, you will receive via email a PDF version of this completed application.

If you are unable to have the form signed electronically before submitting, please have the printed PDF signed by your rector/vicar and senior warden. (Clergy do not need endorsement signatures)

The signed application can then be scanned and emailed, or mailed to Lisa Anderson, registrar@anglicandoma.org, Registrar, Diocese of the Mid-Atlantic, 14851 Gideon Dr., Woodbridge, VA 22192. If submitting electronically, please make sure the file name of this document includes the applicant’s name.

Applications are due by October 1, 2026.
Candidate for (select one)*

Constitution & Canons CommitteeEcclesiastical Trial CourtProvincial DelegateStanding Committee
Name:*
(First & Last)
Mailing Address:*

Street Address, City, State, Zip

Street Address Line 2

CityState / Province

Postal / Zip Code
E-Mail Address:*
example@example.com
Preferred Phone*
Format: (000) 000-0000.
Your Church Name:*
Are you member of the Clergy or Laity?*

ClergyLaity
If laity, have you been confirmed or received by a Bishop of the Province or another province of the Anglican Communion?

YesNo
If laity, are you an eligible voter in your local church? (See footnote below.)

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

Yes
Read the Declarations of the Province and the Jerusalem Declaration.
Signature*
Endorsement of Nomination:
Rector's/Vicar's Signature
Senior Warden's Signature
(Clergy do not need Endorsement signatures)
Title 1B, Canon 1, Section 3(1): Eligible Voters: Only those Members of the Congregation who are at least 16 years of age, who are also recognized by the Rector as regular worshippers and the Treasurer or Wardens as regular contributors are eligible to vote for Vestry and other matters requiring the vote of the Congregation...No person shall be an Eligible Voter in a Congregation or Mission of this Diocese while at the same time holding equivalent status in another church regardless of denomination.

SYNOD 2026

Candidate Nomination Form for Diocesan Positions

Endorsement of Nomination:

Questionnaire for the Nomination Booklet

Questions: (please keep answer length to one paragraph for each question)