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Contact Information

Name*

Prefix First Last

Church Office*

Ruling Elder
Teaching Elder

Preferred Phone Number*

Text Messaging Ability*

I can receive text messages on my preferred phone number
I cannot receive text messages on my preferred phone number

Preferred Email Address*

Mailing Address*

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

Congregational Information

Congregation Name*

Congregation Website

if applicable

Presbytery Name*

What is your congregation's annual income?*

How many communing members are there in your congregation?*

When was the last year that your congregation sent any REs to General Assembly?*

The last time your congregation sent REs to General Assembly, how many REs were sent?*

Have you ever been a commissioner to General Assembly before?*

Additional Applicant Information

For the upcoming GA, to which committees have you been appointed or expect to be appointed?*

Are you willing to share a room with another commissioner at GA?*

If applicable, please list the Teaching Elders serving in your congregation and/or on your session. We may contact any/all of them as references.*

You may list any man in your congregation serving the PCA as a Senior Pastor, Associate Pastor, Assistant Pastor, or in another ministerial capacity (e.g., Out of Bounds, RUF Minister, etc.). If not applicable, please indicate such is the case with "N/A."

If applicable, please list any other PCA Teaching or Ruling Elders serving OUTSIDE of your current congregation and that know you. We may contact any/all of them as references.*

If not applicable, please indicate such is the case with "N/A."

Will your spouse be attending GA with you?*

Yes
No

Assistance Requested - For what kind of financial assistance are you applying?

Registration Fee Assistance*

$450 – Teaching and Ruling Elders
$300 – Elder from a churches with less than $100,000 in annual income (per their 2020 statistics)
$150 – Honorably Retired Teaching Elder
$150 – Ruling Elder Emeritus
Not seeking registration fee assistance

NOTE: If you are approved for registration fee assistance, MORE in the PCA will register you as a Commissioner at the 49th General Assembly. Please do not register yourself and seek reimbursement later.

Shared Hotel Room Accommodation Assistance*

I want shared hotel room accommodation assistance
I do not want shared hotel room accommodation assistance

NOTE: If you are approved for shared hotel room accommodation assistance, MORE in the PCA will place you in a room and pay for it. Please do not seek reimbursement for your own hotel room reservations.

Travel Expense Assistance*

I would like my travel expenses to be reimbursed
I will not be seeking reimbursement of my travel expenses

How much travel reimbursement are you seeking?

Please enter a dollar amount.

To whom should we make the travel reimbursement check payable?

Your church? You?

To what address should we mail the travel reimbursement check?

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

Notes and Additional Information

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Funding Application Form 2022

Contact Information

Congregational Information

Additional Applicant Information

Assistance Requested - For what kind of financial assistance are you applying?

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