Women-Church Convergence: Membership Information

ORGANIZATIONS ARE INVITED TO APPLY FOR MEMBERSHIP IN

To receive an application for membership to Women-Church Convergence,
please print out this page, complete the information,
and send it to the indicated address. Thank you!

Name of Representative ______________________________

Organization _______________________________________

Address __________________________________________

City/State/Zip ______________________________________

Phone ___________________________________________

Fax ______________________________________________

E-mail ____________________________________________

Number of members _________________________________

Local group __________ National group ____________

Individuals are encouraged to make donations to support the work of
Women-Church Convergence.

Name ____________________________________________

Address __________________________________________

Women-Church Convergence, Inc. is incorporated as a 501(c)3 non-profit organization.

Women-Church Convergence
c/o Susan Farrell
20 Snowflake Lane

Edison, NJ 08820
Office phone: 718 - 368 - 4511
Fax: 718 - 368 - 4887
email address: sfarrell@prodigy.net