Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Date *Church Name *GSC Council *FEBRUARYJUNEPastor's Name *Church Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Local President Name *Local President Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeLocal President PhoneLocal President EmailSubmitted By Who *Are You Reporting More Than 10 Singles? *YesNoPlease Select How Many Singles Are Reporting *1 - $10.002 - $20.003 - $30.004 - $40.005 - $50.006 - $60.007 - $70.008 - $80.009 - $90.0010 - $100.00Church ReportChurch Report ($25.00)Monthly Singles Dues - $10.00 [per single]Monthly Singles DuesGSCSA State Membership Dues [per single]State Membership Dues ($35.00)International Singles People Auxiliary (ISPA) Annual Membership (per single)Church Report ($35.00)State President Love OfferingState President Love Offering ($20.00)TOTAL DUE:$0.00Please Select Method of Payment *Credit/DebitPayPalStripe Credit Card *CardName on CardWebsiteSubmit
