When a new church is organized, the session shall apply for the new church's admission into the presbytery in whose bounds it is located. The following form may be used:

TO THE PRESBYTERY OF ______________________________

The undersigned respectfully declare that on the _______________ day of ________________, AD __________, a new church was organized at _______________________________ by the Reverend ____________________________ (or a commission of presbytery), which adopted the principles of the government of the Cumberland Presbyterian Church/Cumberland Presbyterian Church in America, and has a membership of _________. The following persons were elected as elders:____________________, _____________________, ____________________. The following persons were elected as deacons:_______________, _______________, _______________.

We apply to be received under your care, and promise as the session to comply with all the duties and obligations enjoined upon particular churches and their officers by the government of the Cumberland Presbyterian Church/Cumberland Presbyterian Church in America.