SYNOD - IN MEMORIAM

Synod-In Memoriam
Full Name of Deceased Minister or Elder

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Date of Death

MonthDayYear
Minister/Teaching ElderRuling ElderOrder of Diaconal Ministries
Congregation/Pastoral Charged Minister or Elder served in
Provide a brief description of service in the church (eg: years of service, offices of service, character gifts which enhanced the life the congregation and/or courts of the church):

0/200
Name of Next of Kin

First NameLast Name
Address for Next of Kin

Street Address

Street Address Line 2

CityProvince

Postal Code
Submitted by

First NameLast Name
Submitter's Email
example@example.com
Should be Empty: