FORM OF LETTER OF DISMISSION The _____ __ _______________ church of _____ ______ _______ To the ____ ___ ______________church __ _______ __________________ Dear Brothern: This is to certify that ___________________ is a member of the church of God and regular standing. And is at own request here-by dismissed from us to unite with you. When we receive notice from you that __________ _____________ has united with you church. Connection with us shall cease. May the blessing of God rest on _______ ___________ and you. Given by order, and in behalf of the ___________ ___________church ________________________Church Clerk Date __________________
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