GIFT Membership Form
Please print, fill out and send with check to:
Women's Ordination Conference • P.O. Box 2693, Fairfax, VA 22031
or you can fax to 703-352-5181 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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© Women's Ordination Conference, 2007