CLC Membership Form
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Mail CLC Form & Dues To: Effie B. Woodard Connectional Lay Council Second Vice President PO Box 26770 Membership Chairperson Charlotte, NC 28221-6770 919.258.6868 CONNECTIONAL LAY COUNCIL 704.599.4630 Ext. 2566 MEMBERSHIP FORM Episcopal District Conference: P. E. District: Local Church: Pastor: Local President:
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Connection Region Conference District Local Church Total Membership Type Code Number of (Connection Amount Sent to CLC Members + Region)
$ 5.00 $ 10.00 Sustaining Life
EXPIRATION DATE: Month & Year Name(s) of Deceased Life Member(s)
LOCAL CONTACT INFORMATION Email address: Telephone #
*Please Complete Local Contact Information
Email Electronic Form To: [email protected] Instructions
Mail CLC Form and Membership Dues to: Connectional Lay Council P.O. Box 26770 Charlotte, NC 28221-6770 Attn: MEMBERSHIPS
Retain copy of membership form and Local Church portion of membership dues.
Send copy of membership form and District portion of dues to District Second Vice President.
Send copy of membership form and Conference portion of dues to Conference Second Vice President.
Note: Regional Director portion of dues are included in amount sent to CLC office.