Delegate Change Form

Each Member Congregation is eligible for one Delegate per 100 confirmed members.

Delegate Change Form

Congregation Information

Church Name *

Church Address *

City *

State *

ZIP Code *

Phone *

I need to

Remove Delegates

Add Delegates

Update Delegate Contact Information

Delegates to Remove

List each Delegate, with their email address, on a separate line.

Delegates to Add

Name of Delegate

First Name *

Last Name *

Address *

City *

State *

ZIP Code *

Telephone Number *

Email *

If no email, type No Email.

Year of Birth *

Delegates to Update

Complete the First Name and Last Name fields and only the fields requiring updates.

Name of Delegate

First Name *

Last Name *

Address

City

State

ZIP Code

Telephone Number

If no email, type "No Email".

Year of Birth

To add eight or more new delegates, please email teresa@thelutheranfoundation.org

Authorization

Pastor's Name *

Pastor's Signature *

Type name as signature.

The parties agree that this form will be electronically signed. The parties agree that an electronic signature appearing in this form is the same as a handwritten signature for the purpose of validity, enforceability, and admissibility.

Date *