Name: _______________________________________________________________

Address: _____________________________________________________________

City_____________________________________ State________ Zip: ____________

Day Phone: ________________________ Evening Phone: _____________________

Email: _______________________________________________________________

I am enclosing my membership fee for an:

__ Individual __Organization

Individual: __ $45 Regular __ $50 International (USD) __ $25 Student/Low Income

Organization: __ $100

In addition, I am enclosing an additional gift of:
___ $25   ___ $35   ___ $50   ___$100   ___ Other $_______

I am paying by:

______ Check (payable to WOC) ______ Credit Card ______ U.S. Money Order

I am using the following Credit Card: _____ Visa _____ MasterCard

Credit Card #: ____________________________________ Expiration Date: _______

Name as it appears on card (print):________________________________________

Signature: ____________________________________________________________

I am called to ordination. ____ Yes ____ No ____ Maybe

____ I have included names and addresses of friends who may be interested in WOC.

____ I am in my 20's or 30's and would like more information about Young Feminist Network.

Can we trade your name with other church reform organizations for use in direct mail campaigns? ____ Yes ____ No

Can we give your name and contact information to WOC members in your area who are trying to do grassroots organizing?* ____ Yes ____ No

* NOTE:
Only requests from WOC members and donors are honored. In addition, the data shared will be limited to a reasonable geographic region solely for the purpose of local organizing.