Name of Congregation:______________________________ City:_______________________________
Congregational
Coordinator
Yes/No Name_______________________________Member / Vistor (Circle one)
Yes/No Name_______________________________Member / Vistor (Circle one)
Yes/No Name_______________________________Member / Vistor (Circle One)
Name _______________________________Member / Vistor (Circle One)
Name _______________________________Member / Vistor (Circle One)
Name _______________________________Member / Vistor (Circle One)
Name and
Address of person submitting this form:_____________________________
Address______________________Tel.:____________City/Zip________________________________
Totals: Total number of Thrivent Members______@ $6.00 each = _$________________
Total of non Thrivent Members _________@$16.00 each =_$________________
Total amount included with this registration $________________
Elections of officers for the 2009 Gulf Coast Chapter leadership board will be conducted at this meeting. Please read the back page of this newsletter, and consider serving.