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Declaration of Intent to Support the Mission of the PCUSA
Name of Church (*)

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City (*)

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We will support the Shared Mission of Presbytery, Synod, and General Assembly. through Mission Treasury Service this year.

We will remit a total of $ (*)


We concur with the action of Presbytery to send 38 percent of our basic mission support to General Assembly and 1 percent to the Synod of the Covenant and to retain 61 percent for the mission and ministry of the Presbytery of Lake Michigan.

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Per capita apportionment, church-wide special offerings, and other specific appeals, i.e. disaster relief, etc. are not a part of Shared or Directed Mission Support and are not to be included with this commitment.



If you DO NOT concur with the recommended percentages, please complete the following. We prefer to send our basic mission support according to the following percentages:

% General Assembly

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% Synod

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% Presbytery

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If you plan to direct a portion of your General Assembly Basic Mission Support, please complete the following. The PCUSA web site (search “Directed Mission”) will provide you with project numbers, names, and procedures to follow.

Program Number/Names/Amount

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Please use the current form from the PCUSA web site (search “Directed Mission”) to request authorization from General Assembly for the direction of your mission support. General Assembly will forward a copy of your approved form to the Presbytery of Lake Michigan

Please indicate your anticipated annual support of the Theological Education Fund. $

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Report Submitted By (*)

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Email (*)

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Telephone Number (*)

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