Faith and Practice of Intermountain Yearly Meeting
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Appendix 5: Examples of Forms and Records
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The Faith and Practice Of Intermountain Yearly Meeting: Appendix 5 - Examples of Forms and Records

Index of Forms and Records

Introduction. 116

1. Records. 116

1a. Recommendations for Monthly Meeting Records. 116

1b. Advices for Preparing the State of the Meeting Report 116

1c. Preparation of Meeting Minutes: Some Useful Practices. 116

1d. Recommendation for Regional, Half-Yearly, or Friends Fellowship Meeting Records. 117

1e. Recommendations for Yearly Meeting Records. 117

2. Census. 118

2a. Sample Monthly Meeting Census Form.. 118

3. Membership. 120

3a. Letter of Welcome to New Member. 120

3b. Monthly Meeting Membership Record. 121

3c. Letter of Transfer. 124

3d. Certificate of Transfer and Acceptance of Transfer. 125

3e. Letter of Release from Membership. 126

4. Travels and Sojourns. 127

4a. Letter of Introduction. 127

4b. Minute of Sojourn. 128

4c. Acknowledgment of Minute of Sojourn. 129

4d. Travel Minute. 130

5. Marriage. 131

5a. The Marriage Certificate. 131

6. Religious Education. 132

6a. First Day School Registration. 132

7. Healthcare and Final Affairs. 133

7a. Cover Letter. 133

7b. Information and Instructions on Health Care Decisions and Final Affairs. 134

Contributions, Records, Gifts. 137

8a. Year-End Contributions Receipt & Request for Information. 137

8b. Archive Deposit Form.. 138

8c. Gift Form.. 139

 


Introduction

The forms in this appendix are templates that monthly meetings can use or modify. Thanks to the Pacific Yearly Meeting Faith and Practice, Albuquerque Monthly Meeting, Boulder Meeting of Friends, Pima Monthly Meeting of Friends, and Salt Lake City Monthly Meeting for sample forms from which these were copied or developed.

1. Records

1a. Recommendations for Monthly Meeting Records

Permanent records should include:

q   Each monthly meeting should keep its own minutes, signed by the presiding and recording clerks. Minutes should include treasurer’s reports and letters sent under concern of the meeting either as attached items or in the body of the minutes.

q   Any financial records not included in the minutes: for example, copies of deeds or contracts.

q   If the meeting is incorporated, records of incorporation and minutes of annual meetings.

q   A membership list of the monthly meeting brought up to date annually by the monthly meeting recorder and submitted, as requested, to the yearly meeting historian/archivist.

q   List of marriages under care of the meeting (whether of members or non-members).

q   Actively maintained membership records of current or past members, including record of births, marriages, deaths, and transfers.

q   Records of final affairs instructions.

q   Records of membership of deceased or removed members.

1b. Advices for Preparing the State of the Meeting Report

The State of the Meeting Report is prepared once a year by each monthly meeting in time to be forwarded to the spring session of its regional, half-yearly or Friends Fellowship meeting. In contrast to the informal reports of activities given to these meetings at other times of the year, the State of the Meeting Report should be a self-examination by the meeting and its members of their spiritual strengths and weaknesses and of efforts to foster growth in the spiritual life. Reports may cover the full range of interest and concerns but should emphasize those indicative of the spiritual health of the meeting. They also include statistical information.

To facilitate the preparation of this report, the Worship and Ministry and Oversight Committees may meet together and explore the spiritual condition of the meeting. They may then formulate a series of queries for a response from the meeting as the basis of the report or may ask one or more of its members to draft a preliminary report for searching consideration by the meeting. After revision and acceptance by the meeting, the report is read at the regional, half-yearly or Friends Fellowship meeting and given to the appropriate meeting committee. A copy should also be sent to the yearly meeting clerk.

1c. Preparation of Meeting Minutes: Some Useful Practices

Expeditious preparation of useful minutes can be aided in many ways. Some suggestions follow.

q   The recording and presiding clerks may study the agenda together in advance of the meeting.

q   An effective minute usually consists of three sections: 1) reasons for the matter before the meeting; 2) decision approved; 3) who is responsible for carrying out the decision, including how it is to be financed.

q   A minute may be drafted in advance for on-site editing as discussion of the matter takes place. (Examples: membership, marriages, matters having clear alternatives.)

q   Oral committee reports should be supplemented by a written version and should include draft copies of action minutes.

q   Assign topical identification to sections of minutes and let the minutes of action be serially numbered (e.g., 1-7:2000 = Minute 1: 7th month; year 2000). Both organizing factors facilitate reference in the future.

q   Use care in distributing and filing copies of the minutes to ensure that those given a responsibility in a meeting have a written copy of the decision.

q   To the extent possible, make minutes themselves complete, interpretable without reliance upon attachments (which often go astray).

q   Some monthly meetings approve all the minutes of a meeting at that meeting, and read them at the next meeting for information only. In other meetings, the recording clerk takes notes and prepares minutes later (except for minutes of action). Those minutes are read for correction and approval at the next monthly meeting.

1d. Recommendation for Regional, Half-Yearly, or Friends Fellowship Meeting Records

Permanent records should include:

q   Minutes, signed by the presiding and recording clerks.

q   Letters or documents sent or published on concern of the meeting, whether or not they are part of the minutes (e.g., sent in the name of a committee).

q   Correspondence about concerns that may come before the meeting.

q   Deeds, wills, property records, if any.

q   Copies of any meeting publications, and any published under its care.

1e. Recommendations for Yearly Meeting Records

Permanent records should include:

q   A copy of the minutes of each yearly meeting, including all its attachments, printed on archival (acid-free) paper or other suitable form, which has been read and signed by the clerks. The attachments should include the reports of the Nominating Committee, the registrar and the treasurer. All epistles from Friends everywhere, or parts thereof that have been read at plenary sessions by the Watching Committee clerk or representative, should be attached, as well as copies of all epistles emanating from Intermountain Yearly Meeting.

q   A copy of the treasurer’s report, separate from the minutes and signed by the treasurer (even if one is attached to the minutes); also reports of any auditors.

q   Copies of minutes of Executive Committee and Continuing Committee.

q   Any minute or letter sent under concern of the yearly meeting, such as travel minutes, that may not be part of the minutes.

q   Complete file of issues of Friends Bulletin and other publications under the care of the yearly meeting.

q   Copies of all handbooks, guides, and disciplines pertaining to Intermountain Yearly Meeting or the regional, half-yearly, and Friends Fellowship meetings that comprise it.

q   Contracts and significant legal documents involving Intermountain Yearly Meeting.


2. Census

2a. Sample Monthly Meeting Census Form

ANNUAL MEETING CENSUS, _____________ MONTHLY MEETING, RELIGIOUS SOCIETY OF FRIENDS

DATE: ______________________________

1. NAME OF PERSON FILLING OUT FORM: _________________________________________________

(same as on line 1 below)

NAME

RELATIONSHIP

TO NO. 1

MEMBERSHIP STATUS

AGE/

DOB[1]

[read footnote!]

MEMBER?[2]

MEMBER of another MEETING?[3]

ATTENDER?[4]

1

 

 

 

 

 

 

2

 

 

 

 

 

 

3

 

 

 

 

 

 

4

 

 

 

 

 

 

5

 

 

 

 

 

 

6

 

 

 

 

 

 

CONTACT INFORMATION (AS OF DATE WRITTEN ABOVE)

STREET OR PO BOX

 

CITY, STATE, ZIP

 

TELEPHONE(S)

 

EMAIL

 


3. Membership

3a. Letter of Welcome to New Member

[address]

[date]

Dear ___________________,

As you know, after some months of discussion and exploration with you, ________________ Friends Meeting acted on your request for membership in its meeting for business of [date], approving a minute recording you as a member in the Religious Society of Friends. On behalf of the meeting, I would like to welcome you as a member. You are more than just a member of ______________ Friends Meeting; you are a member of ______________ (Regional, Half-Yearly, Friends Fellowship), and Intermountain Yearly Meeting. As a member of the Religious Society of Friends, you should feel welcome and comfortable in meetings wherever you might visit.

Our meeting would like to acknowledge your membership with a gift of ______________.[5]

In Friendship, Peace and Love,

Signature (clerk, recording clerk, clerk of Ministry and Oversight Committee, etc.)

 


3b. Monthly Meeting Membership Record

No. _______

Member’s full name___________________________________________________

First Middle Last (Maiden)

Date of birth_________________________Place of birth_____________________

Month Day Year

ADMISSION

Date______________________________By birth_______By application________

Month Day Year

By certificate of transfer from ____________________________ Monthly Meeting

PARENTS

Father’s name ________________________________________________________

Mother’s name _______________________________________________________

ADDRESSES

Year Street Town State Phone

_______ _________________________________________________________

_______ _________________________________________________________

_______ _________________________________________________________

_______ _________________________________________________________

_______ _________________________________________________________

_______ _________________________________________________________

_______ _________________________________________________________

TERMINATION

Date______________ By certificate to ______________________Monthly Meeting

By resignation________________ By release ______________________________

By death________Date of death___________Place of burial___________________

REMARKS

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

 

Date Record Closed_________________________________

 


MARRIAGE

 

To whom married ____________________________________________________

Date _______________________ Place ___________________________________

SPOUSE

Membership (where)___________________________________________________

Birthdate____________________ Place___________________________________

If deceased: Date ______________Place of burial___________________________

Parents of spouse:

Father’s name _______________________________________________________

Mother’s name_______________________________________________________

CHILDREN

Name _________________________ Membership (where) ___________________

Date of birth _________________________Place of birth_____________________

Date of marriage______________________ To_____________________________

Name _________________________ Membership (where) ___________________

Date of birth _________________________Place of birth_____________________

Date of marriage______________________ To_____________________________

Name _________________________ Membership (where) ___________________

Date of birth _________________________Place of birth_____________________

Date of marriage______________________ To_____________________________

 


3c. Letter of Transfer

[date]

Cambridge Monthly Meeting

5 Longfellow Park

Cambridge, Massachusetts 02138

Dear Friends,

Enclosed is our CERTIFICATE OF TRANSFER for __________________, made at her/his request. On the acceptance of this transfer by Cambridge Monthly Meeting, please return a copy to us.

A copy of our membership record for _____________ is enclosed for your retention.

Sincerely,

 

_______________, Clerk

 

Enclosures:

Enclosures:

Certificate of Transfer

Acceptance of Transfer

Membership Record


3d. Certificate of Transfer and Acceptance of Transfer

 

CERTIFICATE OF TRANSFER1

TO: CAMBRIDGE MONTHLY MEETING

At: 5 Longfellow Park, Cambridge, Massachusetts 02138

Dear Friends:

_________________________, a Member of this Monthly Meeting, residing in your area, has requested transfer of the record of her/his membership. The usual inquiry has been made, and with clearness we commend _________________ to your loving care.

We minuted ____________’s admission to membership the 3rd day of Second Month, 1980.

On behalf of ALBUQUERQUE MONTHLY MEETING,

1600 Fifth Street, Albuquerque, New Mexico, 87102.

Minuted the 7th day of Eleventh Month, in the year 1993.

___________________________

Clerk

ACCEPTANCE OF TRANSFER

This Certificate of Transfer for ___________________________ was read and accepted by

CAMBRIDGE MONTHLY MEETING

Minuted the ___________day of _____________month, in the year ____________.

______________________________

Clerk

[1] The Meeting holding the original record prepares this form as completely as possible. Spouses and minor children may be included in one form, but separate certificates are required in other cases. The original and a copy are forwarded to the receiving meeting, and a copy is kept by the originating meeting. When completed, the copy is returned to the originating meeting. The original and copy become part of the permanent records of the respective meetings. Copies may be made for retention in the Clerk’s records.


3e. Letter of Release from Membership

[address]

[date]

Dear ___________,

Thank you for your letter of DATE requesting to resign your membership in the _______________ Friends Meeting. Although we are sorry to see a member drift from us and the Society when we remember your vibrant participation in _____________Friends Meeting, we recognize the truth that Quakerism may not always satisfy one’s spiritual needs, especially at a distance. The Oversight Committee considered your request and felt united in recommending to the Meeting that you be released from membership. In its meeting for business of DATE , ____________ Friends Meeting of the Religious Society of Friends approved a minute releasing you from membership.

We hope that your future spiritual journey will be fruitful for you, whatever direction it may take. If you should find that you are drawn into membership in your local Friends meeting, do write to us so we may forward your membership record to them. Of course you are always welcome to worship with us if you are in this area.

With love,

Clerk




 

4. Travels and Sojourns

4a. Letter of Introduction

[Date]

[Address]

Dear Friends of New York Yearly Meeting,

We send you warm greetings with our member Elizabeth Gray Vining.

Elizabeth spent many years in Japan, and has recently written a biography of Rufus Jones. We find the combination of her global perspective on life and her in-depth knowledge of Quakerism a wonderful asset to our meeting. We are confi­dent you will enjoy her presence at the annual session of your yearly meeting.

We look forward to hearing from her about how the Spirit is moving among Friends in New York.

In Peace,

Sarah Fuller

Clerk, Big Sur Monthly Meeting

[This is a fictional letter signed by the clerk of the meeting (someone else may have actually drafted the letter). It was written at the request of Elizabeth Gray Vining, who knew that it was common practice to bring a letter of introduction when traveling among Friends. Although it would be a courtesy for the clerk to inform business meeting that the letter was written, the meeting is not asked to approve the letter. If Elizabeth had been traveling under a particular concern, the meeting might have considered approving a travel minute (see sample 4d).]


4b. Minute of Sojourn

Radnor Monthly Meeting

Religious Society of Friends

Conestoga and Sproul Roads

Villanova, PA 19085

[date]

Clerk

Redwood Forest Friends Meeting

P.O. Box 1831

Santa Rosa, CA 95402

Dear Friend:

______________ has requested that her membership at Radnor Meeting be changed to that of a sojourning member of Redwood Forest Friends Meeting in Santa Rosa, California.

She left Pennsylvania in [year] but has continued her membership at Radnor while living in Marin County, California, Boulder, Colorado, and now in Santa Rosa.

Many of her friends at Radnor have fond memories of her and wish her well in her present home. She anticipates moving to Corvallis, Oregon, within the next year and will then request a transfer of membership.

Sincerely yours,

Clerk


4c. Acknowledgment of Minute of Sojourn

Redwood Forest Monthly Meeting

P.O. Box 1831

Santa Rosa, CA 95402

July 14, 20xx

Radnor Monthly Meeting

Religious Society of Friends

P.O. Box R 196

Radnor, Pennsylvania 19087

Dear Friends:

We have received your sojourning minute for ______________ and accepted her as a sojourning member of Redwood Forest Monthly Meeting at our meeting for business held [date]. We are glad to welcome her as a sojourning member. Ever since she and her son began attending our meeting, they have been much loved. She has been involved with the children and young people of our meeting, and her care and attention in this regard is greatly appreciated. We know that she will probably be moving on in [year], but are glad of her presence while she is with us.

With loving greetings,

Clerk


4d. Travel Minute

Dear Friends,

Our member Jim Corbett is traveling under a concern for undocumented immigrants. Our meeting has worshiped with him many times as we considered this issue and his leading to travel among Friends. We have no doubt that he is genuinely called to be with you and seek new Light with you about God’s intentions for undocumented immigrants in this country.

We entrust Jim Corbett to your care, and pray that you and he feel the presence of the Light as you meet together.

Signed,

Clerk, Pima Monthly Meeting of Friends

 

[Although this fictional example is written as a letter, it is a minute from a meeting. It records that the meeting affirms the Friend’s leading to travel under a concern. (The meeting probably used a clearness committee to examine this leading.) The meeting need not necessarily unite with the concern.]


5. Marriage

5a. The Marriage Certificate

Whereas, A.B., of, son/daughter of C.B., of and D. , his wife, and E.F., of , daughter/son of G.F., of and H., his wife, having declared their intentions of marriage with each other to Monthly Meeting of the Religious Society of Friends, held at , according to the good order used among them, and having the consent of parents (or guardians), their proposed marriage was allowed by that Meeting.

Now these are to certify to whom it may concern, that for the accomplishment of their intentions, this day of the month, in the year of our Lord , they, A.B. and E.F., appeared in a meeting for worship of the Religious Society of Friends, held at, and A.B. taking E.F. by the hand, did, on this solemn occasion, declare that he/she took him/her, E.F., to be his/her wife/husband/partner, promising, with divine assistance, to be unto him/her a loving and faithful wife/husband/partner so long as they both shall live (or words to that effect); and then, in the same assembly, E.F. did in like manner declare that he/she took him/her, A.B., to be his/her wife/husband/partner promising, with divine assistance, to be unto him/her a loving and faithful wife/husband/partner so long as they both shall live (or words to that effect). And moreover, they, A.B. and E.F., according to the custom of marriage, did, as a further confirmation thereof, then and there, to these presents, set their hands.

A.B.________________________________

E. B. or E.F._________________________

And we, having been present at the marriage, have as witnesses set our hands the day and year above written.

____________________________ ________________________

____________________________ ________________________

____________________________ ________________________

 

[Variations on the traditional certificate may be prepared by the couple in consultation with the Arrangements Committee, or preprinted traditional forms may be ordered from Philadelphia Yearly Meeting Office, 1515 Cherry Street, Philadelphia, Pennsylvania 19102.]


6. Religious Education

6a. First Day School Registration

SCHOOL YEAR (20xx – 20xx)

Religious Education Committee

________________Friends Meeting

Name of young Friend: _____________________________________________

Birthdate:_________________________ School grade fall _________________

Medical concerns or other things Religious Education Committee should know:

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Parents, Grandparents, Partners:

__________________________________________________________________

 

During class [TIME] we will be _________________________________________

___________________________________________________________________

(where responsible party can be found)

Home address:_______________________________________________________

Phone: ___________________ E-mail: __________________________________

Please contact your young Friend’s class leaders or any member of the Religious Education Committee any time you have ideas, suggestions, or concerns. You are always welcome to visit a classroom. Please sign up to provide a snack at least once during the year and know of the First Day School’s appreciation.

 


7. Healthcare and Final Affairs

7a. Cover Letter

[Date]

Dear Friend,

Many Friends meetings support their members by having them share information that will be helpful at the time of their death. It is a loving act to communicate these wishes to their family and spiritual community. We hope the following information will be helpful.

The questionnaire attached is from the _____________Committee of the ____________Monthly Meeting and seeks to learn what you would like the meeting to do in the event of your death. How would you direct the meeting to act with respect to notification of others, obituary information and arrangements for memorial or funeral services and burial or cremation? You may need additional paper to include all that you wish. Please return the questionnaire to [POSTAL ADDRESS]. If you prefer to use a computer document via e-mail, you may request a copy from [emailaddress@something.comnet].

If you find that the information sought does not cover areas you wish covered, please add what you wish. You may leave some questions unanswered because they are not important to you. If you have questions, you may contact any member of the_________ Committee.

In seeking this information, the meeting wishes to be helpful but not to intrude. After your death, your survivors would be responsible for contacting the meeting to confirm your wishes as you have recorded them here. Your survivors would not be bound by this document. It is not a contract, but a simple set of preferences.

[Additional information about possible local arrangements for simple burial or cremation may be provided here.]

 

Grief and Bereavement Committee

___________________,_Convenor

 

[In general, this letter and the accompanying forms would be sent to members and regular attenders every five years, so that they can update the appropriate information.]


7b. Information and Instructions on Health Care Decisions and Final Affairs

name date

address______________________________________________

c yes c no I have completed a Durable Power of Attorney for Health Care Decisions.

c yes c no I have completed forms to be an organ donor

A copy of my DPAHCD and/or organ donor form is located:

I request that the Society of Friends carry out the following upon my death:

The information below may help the Society of Friends carry out my wishes. (Please write on back of form when there isn’t enough room on the front.)

1. Persons to notify immediately (next of kin, executor etc.):

name phone number

address relationship ___________

name phone number

address relationship___________

Is there an individual who is prepared to assume direction of affairs after your death (family member or friend, lawyer)? Name and address?

Is there something the Friends Meeting should do?

Who is able to see to dependent children or others in need?

2. Member of _____________Memorial Society

address

telephone

location of contract

3. Disposal of body

c burial c cremation c medical research

Preferred site for disposal of ashes:

Cemetery preferred: c common plot c family ploT

location of deed

location of release papers

undertaker preferred

4. Burial insurance

insurance company policy number

If no insurance, the expenses will be met as follows:

5. Services desired, and who should conduct the services:
c Memorial Meeting for WorshipSpecial Requests:

Wishes Concerning a Memorial Service:

(Do you want a Friends memorial service at the Meetinghouse? (We can accommodate only number people here.) Would you want a larger gathering or a more private event for your closest friends or family? Do you want to suggest special mementos or photos of your life? Would you like to have music (what suggestions)? Would you like flowers? The more specific you are, the fewer decisions your loved ones will need to make.) Please write detailed requests on the back of the form.

Ongoing Remembrance:

(Do you want your loves ones to plant a tree in your honor, to make a charitable donation in your name, to gather for an annual reunion at a favorite spot, or some other form of continuing remembrance?)

6. Flowers will be accepted c

where

in lieu of flowers, contributions may be made to

7. Special instructions if death is distant from home:

8. My will and/or other legal documents are located:

9.  If no surviving parents, instructions on care of minor children (over)

10. (Information for death certificate (must agree with legal records and policies)

full legal name

present address:

date of birth birthplace citizenship

occupation present employer

title address

father’s name

mother’s name

received BY meeting _______________________ date _________

signature ________________________________________________


You may use additional pages as desired or necessary.

BIOGRAPHICAL INFORMATION for Obituaries

Date of Birth:

Place of Birth:

Father’s Name:

Mother’s Name (include Maiden Name if desired):

Educational Information:

(Schools attended and dates, degrees or certificates awarded)

 

Marriage(s):

(Date and name of spouse, indicate whether this is a current marriage)

 

Children:

(Name, birth date, and address or contact information)

 

Other Relatives:

(Parents, siblings, and significant relatives, including address or contact information) (Also indicate significant deceased relatives who are important)

 

Employment & Occupational Information:

(Either usual occupation, or longer list, including years if desired)

 

Military History (if applicable):

(Veterans might include branch of service and service number, ranks and dates)

 

Special Interests, Activities, and Achievements:

(Include community involvement, hobbies, organizations, etc.)

 

Recent Life:

How long in this area, and relations to the community.

 

Residential history (if desired): (Other communities in which significant time & events occurred)

What media do you want contacted for obituary notices?

(Specify newspapers in selected communities, professional newsletters, alma mater, and/or other.)

 

You are invited to begin drafting your obituary notice if you feel inclined to do so. You also might give some thought to the dispersal of your personal possessions and communicate those wishes to several people.


Contributions, Records, Gifts

8a. Year-End Contributions Receipt & Request for Information

 

Dear Friends,

Thank you for your financial support of _____________Monthly Meeting during calendar year _____. For purposes of supporting charitable tax deductions you may report to the IRS, our records show that your financial support to _______Meeting totaled:

$_____________1

On behalf of _______Monthly Meeting, thank you for your generous support of _______ Monthly Meeting. The Meeting’s important work has been enhanced by your financial support.

Below is an anonymous and completely nonbinding estimate of changes in support you anticipate for the coming year. This is solicited for budget and planning purposes only and is seen only by the meeting treasurer (and/or Finance Committee). If you are willing to provide the estimate of changes, please tear off at the line below and return to the Treasurer, either by means of the donation box or the treasurer’s files folder.

Thank you,

______________, Treasurer

 

[1Some monthly meetings provide a breakout of directed contributions and then show the total.]

 

____________________________________________________________

To the treasurer, _____________Monthly Meeting

I expect my/my family’s financial support for ______Meeting in [YEAR] to:

______ Increase by $_________

______ Decrease by $_________

______ Remain approximately the same

 


8b. Archive Deposit Form

Intermountain Yearly Meeting Archives

Deposit Form

Date:

the IMYM archives at ________________ has this day received the following records from ___________________________________________________.

These documents are to be stored at_____________ and may be removed permanently by minute of the depositing organization or temporarily by letter from clerk or archivist authorizing it for such use as historical display. The liability of the [archive location], by reason of the deposit, is limited to the exercise of their accustomed and reasonable care and diligence in guarding the deposits against loss by fire, theft, and mutilation. The material will be kept under the same conditions as the rest of the collection, and it will be subject to consultation only under the personal supervision of the librarians.

[location of IMYM archives]

By _________________________________________________

IMYM Archivist


8c. Gift Form

I/we hereby give, transfer, and deliver all of my/our right, title, and interest in and to the property described below to the __________________________ as an unrestricted gift and dedicate to the public without restriction and thereby place in the public domain whatever literary rights I/we may possess to this property.

Dated this ____ day of ______________, 20xx

1.  Signature ___________________________________

Address _________________________________________________________

2. Signature ____________________________________

Address __________________________________________________________

3. Signature _____________________________________

Address __________________________________________________________

I hereby accept and acknowledge as an unrestricted gift to ______________ the items or collection described below and agree to administer them in accordance with ___________________established policies.

Dated this __ day of ____________, 20xx

Accepted by:

Signature Title

Description of the material:


 



[1] Optional. Only members or attenders under the age of 18 should answer this question. Age as of date written above. Date of birth is optional – this information is to be used only for purposes of determining when “adult” membership status might be considered and when a young Friend will be subject to registration for the military draft.

[2] Has had a clearness committee through this MM and has been accepted as a Member, has transferred membership from another Meeting, or is a minor child of an adult member of this MM. (write “child.”)

[3] Is a member of another Friends Meeting, if so, write the name and location of that Friends Meeting.

[4] Attends this MM regularly but is not yet a member.

[5] Some Monthly Meetings give a book, a subscription to Friends Bulletin, a copy of the IMYM Faith and Practice, or other item.