Diocese of Southwestern Virginia

Diocese of Southwestern Virginia

CERTIFICATE OF ELECTION OF DELEGATES AND ALTERNATES

TO COUNCIL 2016 (January 29, 30, 31)

This form certifies to the diocesan offices that the people listed were elected to represent the parish’s representatives to Council. It does not serve as Council registration. Every person named on this certificate will receive registration materials in November 2015.

Delegates’ term of office begins effective APRIL 1, 2015.

Please return this form by March 31, 2015 to: Certificate of Election, PO Box 2279, Roanoke, VA 24009

This is to certify that in accordance with Canon 2, Section 2, at a meeting of the Vestry, or Members of ______(name of parish),______(name of city or town), held on ______(date), the following communicants in good standing of the said parish were elected to serve as:

Delegates to Council 2016

(Copy if more room is needed. List alternates on the next sheet.)

Name:______

Mailing Address (with ZIP!):______

______

Preferred Email address:______( ) home ( ) work

Preferred Telephone (with area code): ______( ) home ( ) work ( ) cell

Name:______

Mailing Address (with ZIP!):______

______

Preferred Email address:______( ) home ( ) work

Preferred Telephone (with area code): ______( ) home ( ) work ( ) cell

Name:______

Mailing Address (with ZIP!):______

______

Preferred Email address:______( ) home ( ) work

Preferred Telephone (with area code): ______( ) home ( ) work ( ) cell

Name:______

Mailing Address (with ZIP!):______

______

Preferred Email address:______( ) home ( ) work

Preferred Telephone (with area code): ______( ) home ( ) work ( ) cell

Alternates to Council 2016

(Copy if more room is needed.)

The precedence of alternates shall be in order of their listing on this certificate.

Name:______

Mailing Address (with ZIP!):______

______

Preferred Email address:______( ) home ( ) work

Preferred Telephone (with area code): ______( ) home ( ) work ( ) cell

Name:______

Mailing Address (with ZIP!):______

______

Preferred Email address:______( ) home ( ) work

Preferred Telephone (with area code): ______( ) home ( ) work ( ) cell

Name:______

Mailing Address (with ZIP!):______

______

Preferred Email address:______( ) home ( ) work

Preferred Telephone (with area code): ______( ) home ( ) work ( ) cell

Name:______

Mailing Address (with ZIP!):______

______

Preferred Email address:______( ) home ( ) work

Preferred Telephone (with area code): ______( ) home ( ) work ( ) cell

Name:______

Mailing Address (with ZIP!):______

______

Preferred Email address:______( ) home ( ) work

Preferred Telephone (with area code): ______( ) home ( ) work

to represent the said parish in the Council of the Protestant Episcopal Church in the Diocese of Southwestern Virginia, to be held on January 29, 30, and 31, 2016.

______Principal Clergy/Senior Warden if there is no Clergy Person

in Charge

______Clerk/Secretary of the Vestry

revised May 2012