Membership Form
							www.religiouslife.com
Yes! I want to become an IRL member today!
I've enclosed my membership dues of:
	$20 — Associate Membership (includes subscription to Religious Life magazine) $25.00 outside of U.S.
	$50 – $100 — Sustaining Associate Membership (includes subscription to Religious Life magazine and Consecrated Life publication)
	Send more information on Affiliate Membership for religious communities and for Catholic organizations/apostolates
Also, I've included a tax-deductible donation to support your important work:
		$10	$35	$50	$75	$100
		$250	$500	$1000	Other ___
I'd like to become part of the IRL's Circle of Support by pledging an ongoing regular donation of: $_____ per month/quarter (circle one)

Name: ___________________________________________________
Address: _________________________________________________
Organization: ______________________________________________
Phone (for credit card purposes): _______________________________
City, State, Zip: ____________________________________________

Please charge $ __________ to my credit card Visa Master Card
Card Number: _______________________________
Expiration date (required): ______________________
Cardholder's signature (required): ____________________________________
Name as it appears on the card: _____________________________________
Please include zip code where credit card is sent: ________________________

Please print this form and send to us. Or call us with your credit card.
Institute on Religious Life
PO Box 410007, Chicago IL 60641
773-267-1195 / 773-267-2044 (fax)