Transfer of Members
This certifies that _________________________ is a member in the _________________________ Church of the Nazarene at _________________________ and at h__ request, is hereby transferred to the _________________________ Church of the Nazarene at _________________________ in the _________________________ District.
When the reception of this transfer is acknowledged by the receiving local church, membership in this local church will cease.
Date _________________________ (year)
NOTE: A transfer is valid for three months only. (111)