States of the Thomas Jefferson DistrictThomas Jefferson District of the UUA
   updated 09-2007
 
TJD Home Page
Chalice Lighter home page

Contact:  Chalice Lighter Committee

Chalice Lighters

Use this form to submit your Pledge, add or change contact or other information

Chalice Lighter



I/We pledge to contribute to help Light a Chalice three times a year. I/We will participate until such time as I/We elect to withdraw my/our membership.

Check the pledge amount, and provide your contact and congregation information.

I/We pledge the following per call (select one):

$100  $50  $35  $25  $20  $15  $10  Other $
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New Chalice Lighter
Currently a Chalice Lighter

I am updating my current-pledge amount
I am updating my contact or other information

Pledger Name:    ( please enter your first and last name)

 E-mail Address: (e.g. Smith@aol.com)    ( address is needed to process this form)

 Mailing Address:     ( Calls for pledges are mailed to you at this address)

 City, State and Zip:    

Congregation (or affiliation):     

Person Submitting Form (if not Pledger):

Additional Comments:

  

 
   
Contact:  Chalice Lighter Committee
Contact: Thomas Jefferson District Office, UUA
9704 Mallard Creek Rd     Charlotte, NC    28262-9738
Phone: (704) 549-0750
toll free (800) 549-0751    Fax toll free:  (866) 648-6928
© Copyright 2005 Unitarian Universalist Association  revised 09-07-07