Last Name:
First Name:
Initial:
Home Address:
P. O. Box:
City: State:
Zip Code:
Home Phone:
Business Phone:
Clergy
Rostered Lay
Lay
Congregation:
Pastor(s):
Membership Preference:
Individual........$25.00
Couple............$40.00
Student...........$15.00
Senior Citizen....$15.00
Lifetime..........$500.00
Local Dues........$20.00
- CONTACTING US -
If you are renewing your chapter membership,
or joining for the first time, please enter the applicable information on
the form. Then click on the print button to generate a hardcopy of the form.
Finally, mail a copy of the printed form with the correct payment to the
following address:
Mail Payment To:
Rev. Gwendolyn Snell
11317 Parklawn Drive
Cleveland, OH 44108
A copy of the application form should also be sent to the corresponding secretary who is responsible for sending out membership cards.
Please do not mail cash. Payment
in U. S. currency only.