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Certificate of Convention Delegates (2022, 154th Convention)

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

Please consult the "Delegates Allowed by Parish 2022" 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 2022" sheet also indicates whether your parish is in arrears on assessment payments to the DIocese or Church Pension Fund, or has not filed a 2021 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.

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

Your parish is in arrears on your diocesan assessment payments (Diocesan Mission Apportionment) prior to January 1, 2022. 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, 2022. 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 2021 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.

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(mm/dd/yyyy)
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Prefix
First Name
Last Name
Suffix
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Lay Delegates
For PARISHES only (Chapels, please complete "Lay Representative" below)

Prefix
First Name
Last Name
Suffix


Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

Prefix
First Name
Last Name
Suffix


Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

Prefix
First Name
Last Name
Suffix


Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

Prefix
First Name
Last Name
Suffix


Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
Lay Representative
For CHAPELS only

Prefix
First Name
Last Name
Suffix


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)

Prefix
First Name
Last Name
Suffix


Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

Prefix
First Name
Last Name
Suffix


Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

Prefix
First Name
Last Name
Suffix


Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

Prefix
First Name
Last Name
Suffix


Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
Alternate Lay Representative
For CHAPELS only

Prefix
First Name
Last Name
Suffix


Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
Youth Delegates

Prefix
First Name
Last Name
Suffix


Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code

Prefix
First Name
Last Name
Suffix


Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country