First Announcement
Beloved in the Lord, since we are responsible for one another as fellow members of the body of Jesus Christ, we are deeply concerned when a member of the body wanders from the Christian way and does not repent. Therefore, it is our painful duty as officebearers of this church to inform you that one of our fellow members has sinned and given offense against God and his church and remains unrepentant to this day despite our prayers and admonitions.

Through his/her unrepentance our brother/sister is breaking the covenant bond with the Lord and his people. Thus, we have suspended his/her participation in the sacraments, the signs and seals of this relationship with our Savior and with one another. We also have suspended the other privileges of communicant membership.

At his/her profession of faith he/she promised to honor and submit to the authority of the church. Let us all pray that our brother/sister may respond positively to the admonitions of the church and return to the God and Father of our Lord Jesus Christ, who in grace and faithfulness desires this brother's/sister's repentance.

Note: Before using the second announcement, the approval of classis shall be secured.

Second Announcement
Beloved in the Lord, since we are responsible for one another as fellow members of the body of Jesus Christ, we are deeply concerned when a member of the body wanders from the Christian way and does not repent. Therefore, the officebearers of the church previously requested your prayers for a fellow member who has remained unrepentant of the sin which gave offense against God and his church.

With a heavy heart we report that the suspension of ____(name)____ and all our admonitions and prayers since that time have not produced in our brother/sister any evidence of repentance or a desire to be restored to fellowship with the Lord and his people. We inform you, therefore, with the advice of classis, that if our brother/sister does not repent, it may be necessary to exclude him/her from membership in the church of Jesus Christ.

Our Lord does not wish that sinners should perish but desires that they turn from their evil ways and live. Therefore, let us all continue to pray for our brother/sister and to plead personally with him/her to mend his/her ways and return to the Lord and his people in repentance and faith.

Third Announcement
Beloved in the Lord, since we are responsible for one another as fellow members of the body of Jesus Christ, we are deeply concerned when a member of the body wanders from the Christian way and does not repent. On previous occasions the officebearers of this church requested you to pray for and plead with a fellow member, ____(name)____, who remains unrepentant of the sin which gave offense to God and his church. With sadness of heart we report that our loving admonitions and prayers still have not led him/her to demonstrate any sign of repentance and faith.

Because he/she continues to reject the admonition and discipline of the church and has broken covenant with the Lord and his people, we find it necessary to proceed to exclude this brother/sister from membership in the church of the Lord. If he/she does not show evidence of repentance by ____(date)____, to our deep sorrow he/she will then be excluded from membership. If any member of the church knows of any valid reason why this should not be done, we urge that person to inform the consistory.

Let us all continue to pray for ____(name)____ and plead with him/her so that he/she may not harden his/her heart completely but may return to the God and Father of our Lord Jesus Christ with confession of sin and assurance of faith.

Form for Exclusion from Membership
Beloved in the Lord, our hearts grieve for our fellow member, ____(name)____, who has not responded to the loving admonition and prayers of this consistory and congregation and who remains unrepentant to this day of his/her sin and offense against God and his church and does not heed the admonition of the church and its consistory. Accordingly, in obedience to the command of God in his Word and with great sorrow, we exclude him/her from membership in the church of our Lord.

We do so to uphold the honor of God and to maintain the holiness of God's church with the prayer that this action will also lead the erring one to repentance. We pray that God may cause him/her to seek forgiveness of sin, renewed union with Christ, and restoration into the family of God, the church.

Prayer for Grace
Holy Father, we are humbled before you. We stand before you with fear and trembling, conscious of our own imperfection, yet conscious also of the responsibility you have given your church to discipline its members. Grieving deeply, we plead that this action may build up your people and cause none to stumble. This we ask in the name and for the sake of Jesus Christ our Lord. Amen.

Declaration
In the name of our Lord Jesus Christ, we hereby exclude ____(name)____ from membership in the church of our Lord, knowing also that God himself excludes him/her from fellowship in Christ and all his blessings as long as he/she persists in his/her unrepentance.

Exhortation
As we are saddened by this event, let us be warned to fear the Lord and live close to him and his Word. Let us not harden our hearts, but let us place ourselves under the discipline of our Master, who lovingly and firmly renews our lives through the ministry of the Word and Spirit and the loving care of his church.

Call to Prayer
Let us all continue to pray that by the grace of the Holy Spirit ____(name)____ may yet come to recognize his/her sin, to show genuine repentance, and to seek restoration to fellowship with the Lord and his people. Let us also pray that the Holy Spirit will use us in our contacts with him/her to that end. Let us now together call on the Lord, confessing our sin and pleading for mercy.

(To be concluded with an appropriate prayer.)

Revision adopted by Synod 1991.