UUPCC Individual Membership Application

The benefits of individual or family membership are:

• Receiving our newsletter three times a year
• Participating in Unitarian Universalist Partner Church Council programs and goals
• Supporting global partnership
  

If you or a friend wish to widen the circle please fill out this form to join us!  Just print and complete this form.
Return this form, along with a check for $30 for an individual membership or $50 for a family membership.
Please make your check payable to "U-U Partner Church Council" and send it to:  UUPCC, P.O. Box 88, Bedford MA 01730-0088.

Date: ________________________    Please check one: ___New Membership   ___Renewal

Name:________________________________________________ Phone:______________________

Address:__________________________________________________________________________

City:______________________________ State/Prov:_____ Zip/Postal Code:_____________ 

E-Mail:_______________________________________________  Fax:______________________

North American Church Name:_______________________________________________________ 

Partner Church Name:______________________________________________________________

If this is a gift membership, please give us your name:

_________________________________________________________________________________

Make your check,in US dollars, payable to: "U-U Partner Church Council".

Mail your check and application to:
     U-U Partner Church Council 
     P.O. Box 88
     Bedford, MA 01730-0088

Note: Canadian members may pay the USD equivalent of the same amount in Canadian dollars.
For example: please send $24.27 USD or $40.45 USD which as of 1/11/06 is the equivalent of $30 or $50 CAD.