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 giving ______ (fill in number) gift memberships
First Gift: ___ $40 Second Gift: ___ $20 Third Gift: ___ $20 Fourth Gift: ___ $20
Act now -- Offer expires November 1, 2007!
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: _______________________________________________________________
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.