Empower Hampton Roads (E.H.R.)
an affiliate of the Gamaliel Foundation

 

 MEMBERSHIP APPLICATION
 printable copy
 

REGISTRATION INFORMATION

Congregation______________________________________________    Date: _____________

_____________________________________________________________________________
Mailing Address                                                                               City                                      State                  Zip

______________________________________________________________________________________
Telephone                                         Fax                                        e-mail address                                     # members

______________________________________________________________________________________
Pastor                                              Telephone                              e-mail address

______________________________________________________________________________________
Board Member                               Telephone                              e-mail address

______________________________________________________________________________________
Board Member                              Telephone                               e-mail address

Each congregation has up to 2 voting seats on the Board of Directors

_____________________________________________________________________________________

PLEDGE INFORMATION

Annual Pledge $ _____________ Initial Payment $ __________ Check # ____________

Pledge Plan:

_____________________________________________________________________________________

Monthly                           Quarterly                                       Semi– Annual                            Annually
_____________________________________________________________________________________

E.H.R office use

 

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P.O. Box 14063 Norfolk, VA. 23518 (757) 615-1006 empowehr@earthlink.net

"We are the people we have been waiting for!"