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Certificate of Convention Delegates (2023, 155th Convention)

This certification may be completed by the Rector, Vicar, Priest-in-Charge, Wardens or Clerk of the Vestry.

Please consult the "Delegates Allowed by Parish 2023" sheet to ensure you add the right number of Lay Delegates (or Lay Representatives, for Chapels), Alternate Lay Delegates (Alternate Lay Representatives, for Chapels), and Youth Delegates.

The "Delegates Allowed by Parish 2023" sheet also indicates whether your parish is in arrears on assessment payments to the Diocese or Church Pension Fund, or has not filed a 2022 Parochial Report. In these cases, you may still certify your parish's Convention Delegates, and they may attend Convention, but they will not have voice or vote until the issue is addressed. Questions about arrears and the Parochial Report may be addressed to the Secretary of Convention at convention@cnyepiscopal.org.

Parish

Email address for confirmation

A copy of your Certification of Lay Delegates will be send to this address for your records.

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It is hereby certified that:

This parish is not in arrears in payment of its assessment for the mandatory portion of the Diocesan Mission Apportionment, or to the Church Pension Fund for the period prior to January 1, 2023.

Your parish is in arrears on your diocesan assessment payments (Diocesan Mission Apportionment) prior to January 1, 2023. You may still certify your parish's Convention Delegates, and they may attend Convention, but they will not have voice or vote until the issue is addressed. Questions may be addressed to the Secretary of Convention at convention@cnyepiscopal.org.

Your parish is in arrears on your pension assessment payments prior to January 1, 2023. You may still certify your parish's Convention Delegates, and they may attend Convention, but they will not have voice or vote until the issue is addressed. Questions may be addressed to the Secretary of Convention at convention@cnyepiscopal.org.

Your parish has not completed the 2022 Parochial Report. You may still certify your parish's Convention Delegates, and they may attend Convention, but they will not have voice or vote until the issue is addressed. Questions may be addressed to the Secretary of Convention at convention@cnyepiscopal.org.

It is hereby certified that:

At a Vestry meeting (fill in date below) the persons listed below were duly elected and were eligible to be chosen as Lay Delegates or Alternate Lay Delegates in accordance with Canon II.1.

Date of vestry meeting in which lay delegates and alternate lay delegates were duly elected and were eligible in accordance with Canon II.1.

(mm/dd/yyyy)

Name of person certifying:

Prefix

First Name

Last Name

Suffix

Lay Delegates

For PARISHES only (Chapels, please complete "Lay Representative" below)

Lay Delegate #1 Name

Prefix

First Name

Last Name

Suffix

Lay Delegate #1 Email

Verify Email

Lay Delegate #1 Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Lay Delegate #2 Name

Prefix

First Name

Last Name

Suffix

Lay Delegate #2 Email

Verify Email

Lay Delegate #2 Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Lay Delegate #3 Name

Prefix

First Name

Last Name

Suffix

Lay Delegate #3 Email

Verify Email

Lay Delegate #3 Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Lay Delegate #4 Name

Prefix

First Name

Last Name

Suffix

Lay Delegate #4 Email

Verify Email

Lay Delegate #4 mailing address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Lay Representative

For CHAPELS only

Lay Representative Name

Prefix

First Name

Last Name

Suffix

Lay Representative Email

Verify Email

Lay Representative Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Alternate Lay Delegates

For PARISHES only (Chapels, please complete "Alternate Lay Representative" below)

Alternate Delegate #1 Name

Prefix

First Name

Last Name

Suffix

Alternate Delegate #1 Email

Verify Email

Alternate Delegate #1 Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Alternate Delegate #2 Name

Prefix

First Name

Last Name

Suffix

Alternate Delegate #2 Email

Verify Email

Alternate Delegate #2 Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Alternate Delegate #3 Name

Prefix

First Name

Last Name

Suffix

Alternate Delegate #3 Email

Verify Email

Alternate Delegate #3 Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Alternate Delegate #4 Name

Prefix

First Name

Last Name

Suffix

Alternate Delegate #4 Email

Verify Email

Alternate Delegate #4 Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Alternate Lay Representative

For CHAPELS only

Alternate Lay Representative Name

Prefix

First Name

Last Name

Suffix

Alternate Lay Representative Email

Verify Email

Alternate Lay Representative Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Youth Delegates

Youth Delegate #1 Name

Prefix

First Name

Last Name

Suffix

Youth Delegate #1 Email

Verify Email

Youth Delegate #1 Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Youth Delegate #2 Name

Prefix

First Name

Last Name

Suffix

Youth Delegate #2 Email

Verify Email

Youth Delegate #2 Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country