| Congregation Information |
| Date of New Enrollment______________ |
| Name of Congregation _________________________________________________________________ |
| UUA District ________________________________________________________________________ |
| Mailing Address of Congregation _________________________________________________________ |
| ___________________________________________________________________________________ |
| Phone Number of Congregation __________________________________________________________ |
| Congregation Website: http://____________________________________________________________ |
| Congregation President's Name, Phone Number, and Email:
____________________________________ |
| __________________________________________________________________________________ |
| Avg. attendance _____ How often do you meet?
_____________________________________________ |
| Please describe any professional ministerial services
you have been using: |
| __________________________________________________________________________________ |
| Avg. number of children in group _______ |
| Church on Loan (COL) Contact Person
Information |
| Name of Contact Person _______________________________________________________________ |
| Address of Contact Person _____________________________________________________________ |
| __________________________________________________________________________________ |
| Phone Numbers of Contact Person (h)_________________________
(w)_________________________ |
| FAX Number _______________________ E-Mail Address ___________________________________ |
| |
| Enrollment Information |
| The Church OnLine (COL) enrollment fee is $299 for a one-year subscription. Your Church OnLine year ends twelve consecutive months after your enrollment. |
| Church on Loan Enrollment Agreement |
| Our group wishes to enroll in the CLF Church OnLine (COL) service. |
| TOTAL.....................(maximum
$299) |
_______ |
|
| We will pay by: |
U.S. check, payable to "CLF" |
| Name & title of check signer (please print): |
| Phone number of signer: |
|
|
credit card |
|
Visa MasterCard Discover |
| Name on card: |
| Card number: |
| Expiration date: |
| Three digit security code (from back side of card) |
| Credit card billing address: |
| Credit card billing city, state, zip: |
| Signature and date: |
|
| SUBMIT FORM |
Please return this form and your payment as soon as possible to ensure your registration for Church OnLine (COL). Make a copy for your own records before you send it to:
Church OnLine Coordinator
c/o CLF
25 Beacon St.
Boston MA 02108-2823
FAX: 617-523-4123 or 00-1-7-523-4123
Phone: 617-948-6150 or 00-1-617-948-6150 |
