"*" indicates required fields About Your ChurchPLEASE NOTE: If you are a congregation with a Bishop's Committee, please be sure you've submitted your Bishop's Committee Request and received approval from the bishop before completing this form.Church City*Church Name*Physical Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Church Phone (if applicable)Church Email (if applicable) Church Website (if applicable) Deanery Northwest Metro Central Southern Parish Administrator/Office Secretary (if applicable)Parish Administrator/Office Secretary preferred email (if applicable) Parish Administrator/Office Secretary preferred phone (if applicable)About Your Clergy (if applicable)Please only list those who are ASSIGNED to your church (not supply - even if long-term supply)Clergy 1 NameClergy 1 Position Rector Associate Rector Priest in Charge Curate Deacon Other Full Time or Part Time? Full Time Part Time Clergy 2 NameClergy 2 Position Rector Associate Rector Priest in Charge Curate Deacon Other Full Time or Part Time? Full Time Part Time Clergy 3 NameClergy 3 Position Rector Associate Rector Priest in Charge Curate Deacon Other Full Time or Part Time? Full Time Part Time Clergy 4 NameClergy 4 Position Rector Associate Rector Priest in Charge Curate Deacon Other Full Time or Part Time? Full Time Part Time Clergy 5 NameClergy 5 Position Rector Associate Rector Priest in Charge Curate Deacon Other Full Time or Part Time? Full Time Part Time Lay LeadershipSenior/Bishop's Warden Name*Senior/Bishop's Warden Email* Senior/Bishop's Warden PhoneSenior/Bishop's Warden Address Street Address City State / Province / Region ZIP / Postal Code Junior Warden Namenot applicable for Bishop's CommitteesJunior Warden Emailnot applicable for Bishop's Committees Junior Warden Phonenot applicable for Bishop's CommitteesTreasurer Name*Treasurer Email* Treasurer Phone*Clerk of the Vestry/Secretary of the Committee Name*Clerk of the Vestry/Secretary of the Committee Email* Clerk of the Vestry/Secretary of the Committee Phone*Clerk of the Vestry/Secretary of the Committee Address Street Address City State / Province / Region ZIP / Postal Code Convention DelegatesArticle VIII, Section 3 of the Constitution of the Diocese of West Missouri: Every parish and congregation in union with the Diocese shall be entitled to be represented in the Convention by one Lay Delegate; and in addition thereto, by one Lay Delegate for each 100 communicants or major fraction thereof, up to 500; and in addition thereto, parishes having more than 500 communicants shall be entitled to one Lay Delegate for each 250 communicants or major fraction thereof, up to 1,000 communicants; furthermore, in addition thereto, parishes having more than 1,000 communicants shall be entitled to one Lay Delegate for each 500 communicants or major fraction thereof, in excess of 1,000. For the purpose of determining the number of Lay Delegates to which a parish or congregation is entitled, the number of communicants of such parish or congregation shall be the number of communicants reported by such parish or congregation [line 11] in its Parochial report immediately preceding that date on which its Lay Delegates are chosen. 0-50 COMMUNICANTS = 1 DELEGATE 51-150 COMMUNICANTS = 2 DELEGATES 151-250 COMMUNICANTS = 3 DELEGATES 251-350 COMMUNICANTS = 4 DELEGATES 351-450 COMMUNICANTS = 5 DELEGATES 451-625 COMMUNICANTS = 6 DELEGATES 626-875 COMMUNICANTS = 7 DELEGATES 876-1250 COMMUNICANTS = 8 DELEGATES 1251-1750 COMMUNICANTS = 9 DELEGATES 1751-2250 COMMUNICANTS = 10 DELEGATESNumber of Communicants Declared on Line 11 of your Parochial Report:*Name*Email* Delegate or Alternate?* Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate NameEmail Delegate or Alternate? Delegate Alternate CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
