620 Park Avenue #311, Rochester NY 14607-2943 | 800-462-9498 toll-free | 585-360-4512 local | 585-486-6529 fax | e-mail

Proud Parish Partnership Form

Please complete the form below, then click the button at the bottom to print.

We support Integrity's mission and wish to become a Proud Parish Partner of Integrity!

Signature of Senior Clergy Person (required):

__________________________________________________________________

Contact Person [for Integrity use only, will not be listed]

Name of Congregation/Organization

Mailing Address of Congregation/Organization

Street Address of Congregation/Organization (if different)

Telephone of Congregation/Organization

E-mail of Congregation/Organization

Web Page URL of Congregation/Organization

Diocese of Congregation/Organization

Level of Support
$5000 $1000 $500 $250 $100

Mail your completed and signed form--along with your check made payable to "Integrity"--to:

Integrity
620 Park Avenue #311
Rochester, NY 14607-2943

Thanks for your support!

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No good thing will God withhold from those who walk with Integrity. Psalm 84:11