Tennessee State Primitive Baptist Convention
Elder John T. Gassaway, President Elder Frank Stevenson, Vice – President
Elder Percy Davis, Treasurer Elder Chazen Brown, Financial Secretary
Annual Session Registration Form
Name____________________________________________________________________________________
Title First Name Middle Initial Last Name
Mailing Address____________________________________________________________________________
Number and Street City and State Zip Code
Association______________________ ____________ Local Church________________________________
Telephone No. ( ) ______________ Fax No. ( ) _______________ E-Mail address____________________
Please check the appropriate box
General:
__ Association - $100.00 __ Church - $100.00
Ministers:
__ Pastors – 50.00 __ Elders - $50.00 __ Licensed Ministers - $25.00
Deacons & Laymen Council:
__ Deacons – 15.00 __ Laymen - $10.00
Women Congress:
__Women Auxiliaries (each Church) – 100.00 __ Mothers/Deaconesses - $10:00
__Women of the Church - $10.00 __Ministers Wives - $10.00
Ushers Congress:
__Association Usher Congress - $50.00 __Ushers Board (each church) - $25.00
__Individual Usher - $5.00
Members:
__Donation - $5.00 __Donation - $10.00 __Other - $________
Youth: Choir:
__ Donation - $5.00 __Donation - $5.00
Amount Received: __________________________
Financial Secretary: _____________________________________
Treasurer’s Signature: ___________________________________
Date: _______________
