Lay Delegate Form DS Special Election

Official Lay Delegate Authorization Form

Metropolitan District Conference

Special Meeting, April 20, 2026

This form is to certify that the named 'lay delegate' will represent the named 'church' as an official voting delegate at the Special Meeting of District Conference of the Metropolitan District of the Christian and Missionary Alliance, April 20, 2026 at Princeton Alliance Church.

Church Name *

Lay Delegate Full Name *

Lay Delegate Email *

The named Lay Delegate and the Church Governing Board both affirm this voting status *

Yes, both affirm

Signature of Church Governing Board Member *

Tip: By typing your name you are officially signing this form on behalf of the church.

Each accredited church of The Christian and Missionary Alliance shall be entitled to send its pastor and two lay delegates. If the voting membership (as reported in the last annual report of the church) is 150 or more, another lay delegate may be sent for each additional 100 voting members or fraction thereof.