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Name _______________________________________________________

Address _____________________________________________________

City __________________________ State ______ ZIP ________________

Phone (h)_______________(w) _______________ (cell) _______________

Fax ____________________ e-mail________________________________

Presbytery ________________________ Synod _____________________

____I request unpublished membership.

2006 Annual membership Fee:____$35; _____$5 Seminary/College

Additional Contributions: __$50, __$100,__$250,___$500,________Other

Please send to: Voices of Sophia, 3 First Light, Santa Fe, NM, 87506