Date ______________________

This is to certify that ____________________________________________, having declared ______ faith in the fundamental doctrines of evangelical Christians, has been received as an affiliate member by _______________________________ Friends Church.

As such, ____ is/are entitled, while retaining membership elsewhere is some evangelical denomination, to the privilege of participation in the business of this meeting, and to be appointed to any office therein.

It is understood that ______ will recognize and fulfill, while this relationship remains in force, the obligation of regular attendance in the services, active moral support of the church and its work, and liberal giving toward its financial program. This membership may be terminated at _____ discretion.

________________________________, Clerk