MEMBER REGISTRATION FORM
Please include a check for $15.00 payable to TIAR
(larger or smaller donations are welcome in consideration of members’ resources)


Name:
Address:
City, State, Zip:
Phone:
E-mail:


(This information will not be shared with any other organization.)

I am interested in the following issues:
___ Poverty ___ Economic Justice
___ State/National ___ Peace & Nonviolence
___ Health Care ___ Other

Thank you for your interest in
The Interfaith Alliance of Rochester.
Please clip this form and mail with your check to:


The Interfaith Alliance of Rochester
P. O. Box 25245
Rochester NY 14625