Please print, fill out and send with check to:
Women's Ordination Conference • P.O. Box 2693, Fairfax,
VA 22031
or you can fax it to 703-352-5181 if using a credit
card
Name: _______________________________________________________________
Address: _____________________________________________________________
City______________________________________State________Zip: ____________
Day Phone: ____________________ Evening Phone: _________________________
Email: _______________________________________________________________
I am enclosing my membership fee for an:
Individual: __ $45 Regular __ $55 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
might be interested in WOC.
____ I am in my 20's or 30's and would like information about Young Feminist Network.
