Information Sheet on Synodical Delegates

You are encouraged to complete this form online: www.crcna.org/SynodResources

DELEGATE to SYNOD 2018 INFORMATION

Thursday, June 7, at 7:00 p.m. through Thursday, June 14

Calvin College, Grand Rapids, MI

CLASSIS: ______

Appointed as: ___ Minister Delegate ___ Minister Alternate

(Check one) ___ Elder Delegate ___ Elder Alternate

___ Deacon Delegate ___ Deacon Alternate

___ Other Officebearer Delegate ___ Other Officebearer Alternate

Full Name: ______

(Title: e.g., Mr., Ms., Rev.) (First) (M.I.) (Last)

Address: ______

(Street)

______

(City) (State/Province) (Zip/Postal Code)

Phone/Home: (______)______Work: (______)______

Cell: (______)______Email: ______

Gender: ¨ Male ¨ Female Birth date (MM/DD/YYYY): ______

Ethnicity: ¨ Asian/Pacific Islander ¨ Black/African American/African Canadian ¨ Caucasian/White

¨ Hispanic ¨ Native American/First Nation ¨Other:______

Local Church Membership: ______CRC in ______

1a. List previous advisory committee experience, if applicable (e.g., Education, Church Order, Global Missions):

b. List years previously served as delegate to synod (e.g., 2003, 2009, 2012 or N/A):

c. Have you previously served as advisory committee chair? Yes/No Advisory committee reporter? Yes/No

2. Of what denominational boards, standing committees, or study committees are you or have you been a member?

3. Of what classical and/or local committees or boards are you or have you been a member?

4. Circle your areas of special interest in the work of synod: Synodical Services (Polity Matters), Church Order and Synodical Matters, Education and Candidacy, Congregational Services Ministry, Global Mission and Ministry, Financial Matters, Ecumenical Relations Matters, Study Committees. Note: Every effort will be made to honor the topics selected; however, there are rules that govern the assigning, such as no two delegates from the same classis can serve on the same advisory committee.

5. If assigned to be a reporter for an advisory committee, are you comfortable working with a laptop and modifying documents that are provided? Yes/No

6. Have you previously served as an officer of synod (President, VP, First or Second Clerk)? Yes/No If nominated as an officer of synod, are you willing and able to serve? Yes/No

7. What other data do you wish to submit that will aid in being assigned to an advisory committee of synod?

8. What is your present and/or previous occupation(s), particularly for elders and deacons?

NOTE: Passports are required for travel across the border. A Synod Travel Policy will be sent with the Delegate Registration packet in April—please wait to make travel/flight arrangements until that time.

PLEASE submit this form no later than March 15 online (www.crcna.org/SynodResources) or forward to

Ms. Dee Recker, Director of Synodical Services