Delegate and Chair Information

Please fill out the form below to document who is assigned to the different roles at your church. The form is also available in PDF format which can be sent to your DS or Bea Stucke at bea.stucke@dakotasumc.org.

Person Filling out this Form (Name, Role): *

Your Church (Name, Town, State): *

Your District in the Dakotas Conference: *

Lay Member to AC 2023

Lay Member Name: *

Mailing Address:

Email:

Phone:

Alternate Lay Member to AC2023

Alternate Lay Member Name: *

Mailing Adress:

Email:

Phone:

S/PPRC Chair Person

S/PPRC Chair Name: *

Mailing Address:

Email:

Phone:

Admin. Board/ Council Chair:

Admin. Board/ Council Chair Name: *

Mailing Address:

Email:

Phone:

Thank you for filling out this form. The fields marked with a star are required and you cannot submit the form if you have left those empty. Please contact Bea Stucke (see email at the beginning)if you have any questions.

Delegate and Chair Information

Delegate and Chair Information

Lay Member to AC 2023

Alternate Lay Member to AC2023

S/PPRC Chair Person

Admin. Board/ Council Chair:

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