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Church Name:
Community:
Annual Meeting Date:
Today's Date:
Position:
Senior Warden Phone #
Junior Warden Phone #
Secretary
Name and Address (include zip code) Mr.
Mrs.
Ms.
Other
NAME:
Address City
State
Cell Mr.
Work Mrs.
Ms.
Other
E-Mail NAME:
Address City
State
Cell Mr.
Work Mrs.
Ms.
Other
Treasurer
NAME:
Address State
Cell Mr.
Work Mrs.
Ms.
Other
ECW Chair
NAME:
Address State
Cell Mr.
Work Mrs.
Ms.
Other
Christian Ed.
NAME:
Address State
Cell Mr.
Work Mrs.
Ms.
Other
Youth Chair
NAME:
Address State
Cell Mr.
Work Mrs.
Ms.
Other
Planned Giving Phone #
Zip Code E-Mail
NAME:
Address City
Phone #
Zip Code E-Mail
City Phone #
Zip Code E-Mail
City Phone #
Zip Code E-Mail
City Phone #
Zip Code E-Mail
City Phone #
Zip Code
State
Cell Mr.
Work Mrs.
Ms.
Other
Zip Code E-Mail
NAME:
Address City Cell
State Work
Zip Code E-Mail
Name and Address (include zip code) Mr.
Mrs.
Ms.
Other
NAME:
Address City Phone #
State
Cell Mr.
Work Mrs.
Ms.
Other
Zip Code E-Mail
NAME:
Address City Phone #
State
Cell Mr.
Work Mrs.
Ms.
Other
Zip Code E-Mail
NAME:
Address City Phone #
State
Cell Mr.
Work Mrs.
Ms.
Other
Zip Code E-Mail
NAME:
Address City Phone #
State
Cell Mr.
Work Mrs.
Ms.
Other
Zip Code E-Mail
NAME:
Address City Phone #
State
Cell Mr.
Work Mrs.
Ms.
Other
Zip Code E-Mail
NAME:
Address City Phone #
State
Cell Mr.
Work Mrs.
Ms.
Other
Zip Code E-Mail
NAME:
Address City Phone #
State
Cell Mr.
Work Mrs.
Ms.
Other
Zip Code E-Mail
NAME:
Address City Phone #
State
Cell Mr.
Work Mrs.
Ms.
Other
Zip Code E-Mail
NAME:
Address City Phone #
Cell
State Work
Zip Code E-Mail
Return this form to PO Box 11937, Harrisburg, PA 17108 The Diocese requests permission to use vestry member email address for distribution of the Diocesan Digest. Vestry members have the option of unsubscribing to the Digest upon receipt.
Total Active Baptized Members reported on line M12 of 2012 Parochial Report _________ Number of Delegates _________ FORM FOR CERTIFICATION OF LAY DELEGATES TO CONVENTION
It is hereby certified that a meeting of the Vestry of _____________________ Church, _________________________, was held on the ___________________day of ___________________, 20__. The following were duly elected Delegates and Alternate Delegates to the 143rd Annual Convention of the Episcopal Church in the Diocese of Central Pennsylvania, to be held in State College, PA on June 7 & 8, 2013 and said Delegates are worshipers in said Church now and have also been for not less than six calendar months before election. DELEGATES (Name, address, email & telephone) 1. Name: Address:
ALTERNATES(Name, address, email & telephone) 1. Name: Address:
Email: Tel:
Email: Tel:
2. Name: Address:
2. Name: Address:
Email: Tel:
Email: Tel:
3. Name: Address:
3. Name: Address:
Email: Tel:
Email: Tel:
4. Name: Address:
4. Name: Address:
Email: Tel:
Email: Tel:
5. Name: Address:
5. Name: Address:
Email: Tel:
Email: Tel:
6. Name: Address:
6. Name: Address:
Email: Tel:
Email: Tel:
7. Name: Address:
7. Name: Address:
Email: Tel:
Email: Tel:
Dated this _______________ day of ________________, 20___ Rector____________________________________Secretary of the Vestry__________________________ Note: Please return one copy of this form NOT LATER THAN April 15, 2013 to: Diocesan Convention co/ Linda Arguedas – (
[email protected]) PO Box 11937 Harrisburg, PA 17108-1937