Assembly Delegate Registration
Louisiana District Church of the Nazarene Delegate Registration. Please complete all requested fields. If you do not have a person serving in requested capacities enter the word "NONE".
Email address *
Church Name *
Your answer
Pastor - Name *
Your answer
Pastor's Email Address *
Your answer
Pastor's Phone *
Your answer
NMI President - Name *
Your answer
NMI President - Email Address *
Your answer
NMI President - Phone *
Your answer
NMI Vice-President - Name number *
Your answer
NMI Vice-president - Email address *
Your answer
NMI Vice-president - Phone *
Your answer
NYI President - Name *
Your answer
NYI President - Email address *
Your answer
NYI President - Phone *
Your answer
NYI Vice-president - Name *
Your answer
NYI Vice-president - Email address *
Your answer
NYI Vice-president - Phone *
Your answer
SDMI Chairperson - Name *
Your answer
SDMI Chair - Email Address *
Your answer
SDMI Chair Phone
Your answer
SDMI Vice- chairperson -Name *
Your answer
SDMI Vice-Chair - Email address *
Your answer
SDMI Vice-chair - Phone *
Your answer
Additional delegates
Delegate - Name; email and phone number; please list all *
Your answer
Alternate Delegates - Name; email and phone number; please list all *
Your answer
Form complete by: Name; position *
Your answer
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