Congregational Remittance Form

Click here to download and print a paper form.

Or submit your information electronically here:

Congregation Name*
Congregation Number*
Congregation Address*
Street Address Address Line 2 City State ZIP Code
Treasurer / Administrator's Name*
First Last
Treasurer / Administrator's Phone*
(for if we have questions)
Treasurer / Administrator's Email*

(to receive a copy of your submission and for if we have questions)
Remittance for*

(Month and Fiscal Year)
Check Number

Please make checks payable, and send, to: NT-NL Synod, ELCA, 680 Copper Canyon Rd, Argyle TX 76226
Total Remittance Amount*
Designations
- Our total remittance amount may go to Mission Support where needed most (NT-NL 52% / ELCA 48%)
- We would like to designate part of our total remittance amount to particular ELCA ministries
- We would like to designate part of our total remittance amount to particular NT-NL ministries
Amount to Mission Support (NT-NL 52% / ELCA 48%)
ELCA Designations
Amount to ELCA World Hunger
Amount to Lutheran Disaster Response - U.S. only
Amount to Lutheran Disaster Response - International
Amount to Campaign for the ELCA
Amount to ELCA Other
Designation for ELCA Other*

Please provide the name(s) of the additional ELCA program(s) you want to support with the amount designated above.
NT-NL Designations
Amount to Bishop's Benevolence Fund
Amount to Bishop Associate's Benevolence Fund
Amount to DEM's Benevolence Fund
Amount to Briarwood Leadership / Retreat Center
Amount to Campus Ministry Fund
Amount to Lutheran Seminary Program in the Southwest
Amount to Lutheran Sunset Ministries
Amount to NTNL Mission Endowment Fund
Amount to NTNL Fund for Leaders
Amount to Sierra Leone - Disaster Relief
Amount to Sierra Leone - General
Amount to Upbring
(formerly Lutheran Social Services of the South)
Amount to Mission Congregation Support
Designation for Mission Congregation Support*

If you would like to designate a particular NT-NL Mission Start
Amount to NT-NL Other
Designation for NT-NL Other*

Please provide the name(s) of the additional NT-NL program(s) you want to support with the amount designated above.

Congregational Remittance Form

ELCA Designations

NT-NL Designations

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c/o Good Shepherd Lutheran Church
2620 W Grauwyler Rd
Irving TX, 75061

940.241.2099

Congregational Remittance Form

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ELCA Designations

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