Progressive
Episcopalians
       of
Pittsburgh

Progressive Episcopalians
of Pittsburgh
#109 4530 Wm Penn Hwy
Murrysville, PA 15668

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       Membership Form

Print this form to fill out and mail or copy to your hard drive and attach to an e-mail to addresses at bottom.

Progressive Episcopalians of Pittsburgh

Membership Declaration

Name:

Mailing address:

Home phone: Work/day phone: FAX:

Email address:

(Please subscribe me to the PEPchat group discussion list Y______N_____ Already subscribed __)

Parish affiliation:

I want to identify myself as a member of Progressive Episcopalians of Pittsburgh.


PLEASE LIST WHAT KIND OF WORK YOU DO, EXPERIENCE, EXPERTISE, HOBBIES, INTERESTS, etc

WORK EMPLOYMENT:

EXPERIENCE/EXPERTISE:

HOBBIES/SPECIAL INTERESTS:

Parish positions, etc.:

Volunteer Work:

I would like to contribute to the work of PEP in the following way(s)

COMMITTEES: STRATEGY ____; LEGAL______; PUBLICITY______; ECCLESIASTICAL ____; DEVELOPMENT______; MEMBERSHIP______; RESEARCH & COMMUNICATIONS______

SUBCOMMITTEES:

Enclosed is my membership offering to PEP for the year Sept. 1, 2003 to
August 31, 2004: $______

Return form to: Susan J. Boulden, 634 Tenth Street, Oakmont, PA
15139-1143 or: [email protected]
 

 

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