North American Conference of Associates and Religious
Congregational Membership Form
Please Print Clearly:
FULL Name of Religious Congregation: _______________________________________
Contact Person:
Prefix ______________ (Br, Fr, Mr, Mrs, Ms, Sr)
First Name: _________________ Last Name:_______________________ Suffix ______
Title: _____________________________________________________________
Address: __________________________________________________________
City: _______________________________ State/Prov: ____________________
Zip/Postal Code: _____________________ Country: _______________________
Phone (W): (_____)_________ Phone (H): (_____)_________ Fax: (_____)__________
Email: _________________________________
Congregation’s Charism/Mission Statement:
Please limit to 50 words or less – use space below or attach a separate sheet:
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This is a
________New Membership __________ Membership Renewal
Fees:
(Congregational Membership fees are sliding scale based on total number of Congregational and Associate members)
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Number of Religious: |
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*It Total Numbers equal: |
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Number of Associates: |
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125 or less |
$150 |
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*Total: |
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126 - 249 |
$240 |
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250 – 499: |
$330 |
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499 or more |
$420 |
Membership Fee _______
Additional Membership Directory (includes postage) $25.00 _______
Additional Subscription(s) to The Associate $25.00 _______
Free will offering to assist NACAR _______
Total Amount Enclosed _______
Send this form and your check to: (American dollars only please)
NACAR
4321 Elm Street
East Chicago, IN 46312
Email: nacar96@ juno.com
1/2007