Church Forms

Bulletin Announcements – If you would like an announcement to be communicated to the church members, email the church office. The deadline to submit announcements is Wednesday 5:00 PM.

Newsletter Announcements – If you would like an announcement to be communicated to the church members email the church office. The deadline to submit announcements is Tuesdays 5:00 PM.

Please fill out this form to request access to the Mosaic Church Directory. By gaining access, you consent for your basic contact information to be included (Name, Phone, and Email). When your invitation is sent you will have 3 days to set up your account, or else you request access again.

Check Request

Checks are requested once a week. Please arrange with the church treasurer or church office if you need reimbursement sooner than a week.

Date of Request: *

Make Check Payable to: *

First

Last

Email of Person Requesting the Check: *

Confirm Email

Amount (total) of checks: $ *

Please make sure a scan of any/all receipts are attached.

Receipt File Upload *

Click or drag files to this area to upload. You can upload up to 20 files.

Please upload images or scans of receipts here.

Ministry Funding Reimbursement: *

Description of Purchase: *

*Reimbursement checks are not usually mailed out. Please specify if you want to have the reimbursement check mailed to you by placing a check mark in the box below.

Please mail my reimbursement check

Your Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Tithe Receipt Request

All tithe receipts must be requested. We no longer print tithe receipts in advance. This allows the process to be efficient and secure. Tithe Receipts will be available on January 20, 2024

Key Request Form

Church Property Request

Please download and fill out the form and submit it to the church office. The form should be submitted 5-7 days prior to use. To get started please click this link Borrowing Church Furniture Procedures

Youth Outing Activity Form

Youth Outing to: *

Proposed Date: *

Purpose of the Outing: *

Destination Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Event Coordinator: *

First

Last

Name of Ministry/Group:

Phone No.

Email *

Describe the event and its purpose: *

Proposed Start or Departure: *

Date

Time

Proposed End or Return: *

Date

Time

Number of Attendees (Including Event Coordinators): *

Number of Chaperones (1 per 8 Youth): *

(Minimum of 2 required)

Chaperone Names: *

Separate names with a comma.

Have all chaperones/adults (18 yrs. and older) completed Sterling Volunteers Backgoround Check? *

If no, they must complete the background check at least 5 days prior to the event. Contact the church office to arrange this.

I understand all attendees under the age of 18 must have parental/guardian permission slips signed to be allowed to participate. *

Sign your name here.

I understand all attendees under the age of 18 must have signed medical release forms to be allowed to participate. *

Sign your name here.

Event Advertising Request (If available)

Sabbath Bulletin
Mosaic E-mail/Newsletter

Desired date to start publishing the announcement:

NOTE: RIDING IN THE BACK OF OPEN VEHICLES IS PROHIBITED (PICKUP TRUCKS, TRAILERS, FLATBEDS, ETC.) DRIVER(S) MUST HAVE A GOOD DRIVING RECORD, BE AGE 21+, AND HOLD A VALID AND CURRENT LICENSE PER TYPE OF VEHICLE AND CURRENT VEHICLE INSURANCE.

REQUIRED CHECKLIST:

Submit Trip Itinerary and Event Coordinator contact information to Church Board and
Parents/Guardians
Two Adults in all vehicles for driving and supervision (Minimum of two adults required – Additional
supervision based on the risk)
- There should be a female adult if female youth are in the vehicle.
- There should be a male adult if male youth are in the vehicle.
Permission and Medical Release Forms (All children under Age 18)[DOWNLOAD HERE]
Submit a copy of each driver's license and car insurance to the church office if using personal vehicles.

RECOMMENDED CHECKLIST:
Qualified Supervision for the type of the activity

First Aid Trained adults with group
First Aid Kit
Emergency Plan provided for the activity
Safety Equipment Available for All Participants (Life Jackets, Safety Gear, Helmets, Knee and
Elbow Pads, etc.)
Cell Phones

If you have license and insurance information already, upload here, otherwise email to office@mosaicsda.org prior to the event:

Click or drag files to this area to upload. You can upload up to 16 files.

I understand Adventist Risk Management and Mosaic Christian Fellowship Seventh-Day Adventist Church requires a detailed itinerary for day/night outings and permission forms for all outings in advance of the event. *

Type Name to Sign

Today's Date:

Offsite Activity Form

Outing to: *

Proposed Date: *

Purpose of the Outing: *

Destination Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Event Coordinator: *

First

Last

Name of Ministry/Group:

Phone No.

Email *

Describe the event and its purpose: *

Proposed Start or Departure: *

Date

Time

Proposed End or Return: *

Date

Time

Number of Attendees (Including Event Coordinators): *

Event Advertising Request (If available)

Sabbath Bulletin
Mosaic E-mail/Newsletter

Desired date to start publishing the announcement:

Today's Date:

Maintenance Request Form

Baptism / Profession of Faith Info Form

Full Name: *

First

Middle

Last

Type of Event: *

Baptism
Profession of Faith
Re-Baptism
Baby Dedication

Officiating Pastor *

Ceremony Date: *

Your Cell Phone #: *

Home Phone #:

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Your Birth Date: *

Your Age:

Church Forms

Sign up for Newsletter!

Directory Access Request

Check Request

Room Reservation Request

Church Event Form

Tithe Receipt Request

Key Request Form

Church Property Request

Youth Outing Activity Form

Offsite Activity Form

Maintenance Request Form

Baptism / Profession of Faith Info Form

Church Involvement Interest Survey

Van Request