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East Cedar Grove Missionary Baptist Association, Inc. 

Smith Thomas Convention

2174 Brassfield Road 

 P.  O. Box 808 

Phone: 919-528-3244

Creedmoor, NC 27522 

CHURCH REGISTRATION FORM - ANNUAL SESSION

Date
Month
Day
Year
Pastor's Information

Delegates: (Please List)

Alternates (Please List)


Finance





Single choice
1 - 50 Members - $250.00
51 - 100 Members - $350.00
101 - 250 Members - $ 500.00
251 - 500 Members - $750.00
501 - 700 Members - $ 1000.00
701 Members and Above - $1500.00

Make check payable to ECGMBA Annual Session. Mailing address: ECGMBA P.O.Box 808 Creedmoor, NC 27522.

Representation Fee: $_______________

Amount Paid: $_____________________

Prepared By:______________________

East Cedar Grove Missionary Baptist Association Church Representation Assessments

(Annual Suggested Payment Plan Based On Church Membership)

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