Membership Form – DUCC

Membership Form

 

Please consider joining with the electronic form below.

To down load and print a copy of the PAR Form.

Another option is to download a print copy of the full Membership Form to fill out and mail.

Printed Membership Forms and payment should be sent to :

DUCC Membership Cluster

c/o Treasurer, Helen Reed,  Box 99,  Oyen , Alberta T0J 2J0
treasurer@ducc.ca

Date (required)            Email (required)      
First Name (required)      Last Name (required)  

Other Email           

Street/Apt/Box        
Community                  Province              
Postal Code                Country               

** ten digit phone numbers please **
Landline                   Cell                  

Presbytery            
Denomination          
Conference            

Diaconal Workplace if applicable   
Identification, are you            
If Other,  please describe         
If this is a recent identification for you, please give details (for example date and place of commissioning
or retirement, etc.)

Which category best describes your current diaconal ministry (pick as many as apply)
congregationalinstitutionaleducationalsocial justicepastoral careadministrativetent makingretiredfull timepart timevolunteerstudentother
Please elaborate if useful


This membership submission will be for
NewRenewalFor Membership Year 

Fees  The suggested fee is $130.00 annually. Payments can be claimed on your income tax as Professional Fees. The
minimum membership fee is $15.  If you are able, you are encouraged to pay $155, which helps to offset for
those paying a lower amount. Any amount contributed above $155 anually will be credited as a donation.
Donations are tax deductible under Charitable Donations.

For pre-authorized withdrawal from your bank account
Download PAR Form and send it along with a VOIDED cheque to
DUCC Treasurer, (address above)
For Annual Payment
Amount      
Donation    

Make cheque payable to Diakonia of the United Church of Canada, and send to the Treasurer.

Church Representation: If you are on a Conference or Presbytery Committee that has responsibility in some way for
diaconal ministry, or as a diaconal rep, please describe.


If you are you on a General Council Committee or Task Group, which one? length of term?


Improving the website content.
Do you have a thesis that is not already on the website? (see Scholarly Works under Meet the Community) If it is
available electronically please attach here. (pdf format is preferred, but doc, docx or wpd is acceptable)

If the thesis is unavailable electronically please detail the Title, degree, school, year and 2 sentence description.


Optional: Attach a recent GOOD QUALITY photo


Have you created your Profile, or have you checked to see that it is up to date?    Thanks for doing that!

Comments


 The information is sent by email to the Treasurer and Membership contact, and to your Email address.  Our system is not without
its glitches sometimes. IF you receive an error message asking you to contact the administrator,
please do not resubmit, email membership@ducc.ca and let us know!   Thanks