To the Classis ______________________ of the Protestant Reformed Churches, to convene ________________, 20____, at _________________________________________
The Consistory of the ___________ Protestant Reformed Church has appointed the brethren _______________ and elder ____________________ as delegates to represent said church at the meeting of classis above referred to. The alternate delegates are: elder ____________________ and elder _________________.
We hereby instruct and authorize them to take part in all the deliberations and transactions of classis regarding all matters legally coming before the meeting and transacted in agreement with the Word of God according to the conception of it embodied in the doctrinal standards of the Protestant Reformed Churches, as well as in harmony with our Church Order.
Instructions:
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By order of the consistory,
___________________________, President
_______________________________, Clerk
Done in consistory _____________, 20_______
(Cf. Minutes of Classis, June 6, 7, 1934; Acts of Synod, 1944, Arts. 66, 67; Acts of Synod, 1945, Arts. 40, 51; Acts of Synod, 1946, Arts. 17, 19.)