Form 18

To the [name of the presbytery] , meeting on the day of in the year , at [location of meeting] .

We the [name of mission church, fellowship, or “undersigned” in case of no current organization] , a body of [number] people located in or around [location within presbytery’s bounds] , confident in Christ’s promises to build His church and convinced by His providence that such a work has begun among us, hereby petition this presbytery to grant the organization of this body into a congregation of the Reformed Presbyterian Church of North America under the oversight of the [name of presbytery] . We believe God has provided men capable of constituting a session and acting as Christ’s undershepherds for us. We seek this privilege from the presbytery with full reliance on God’s grace and not on ourselves.

Given this day of in the year by request of the undersigned.

Temporary Governing Body

Ruling Elder(s)-elect (as applicable) Teaching elder(s)-elect (as applicable) Communicant Members (as applicable) Adherents (as applicable)