Registrar Contact Form

Delegation Information

Delegation Name:

Delegation Type:

Presbytery Delegation
Church Delegation
Caucus Delegation

Denomination:

Presbyterian Church (USA)
Cumberland Presbyterian Church

Has this delegation attended Triennium before?

Yes, in 2019
Yes, but not in 2019
No

Registrar Information

Please provide the following information about your delegation’s registrar. If your delegation has more than one registrar, please fill out a separate form for each individual. Thank you!

Name:

First Last

Preferred Name (if different from First Name):

Email:

Cell Phone:

Cell Phone: Day Phone (if different):

Evening Phone (if different):

Fax Number:

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Type of Mailing Address:

Church
Mid Council
Residential
Other Business

Place of work:

Has this person served as a registrar before?

Yes, in 2019
Yes, but not in 2019
No

Does this registrar plan to attend Triennium with the Delegation?

(It is in no way required for registrars to attend PYT.)

Yes
No
Unsure