* Online Gift Membership Form * Or, fill out and send with check to:
Women's Ordination Conference • P.O. Box 15057, Washington,
DC 20003
or you can fax to 202 675-1008
if using a credit
card
Your Information
Name: _______________________________________________________________
I am enclosing gift membership fees for an: ____ Individual ____Organization
Individual: __ $45 Regular __ $50 International (US$) __ $25 Student/Low Income
Organization: __ $100
I am enclosing an additional gift of:
___ $25 ___ $35 ___ $50 ___$100 ___ Other $______
I am paying by:
______ Check (payable to WOC) ______ Credit Card ______ Money Order
I am using the following Credit Card: ______ Visa ______ MasterCard
Credit Card #: ___________________________________ Expiration Date: ________
Name as it appears on card (print):________________________________________
Address associated with credit card:
Street Address_________________________________________________________
City, State, Zip: _______________________________________________________
Phone: _______________________________________________________________
Email: _______________________________________________________________
Signature: ____________________________________________________________
Gift Member Information
Name: _______________________________________________________________
Address: _____________________________________________________________
City________________________________________State_______Zip: ___________
Day Phone: ________________________ Evening Phone: _____________________
Email: _______________________________________________________________
Gift member is
called to ordination:
____ Yes ____ No ____Maybe ___ Not Sure
____ Gift member is in her/his 20's or 30's and would possibly like information about Young Feminist Network.
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