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Congregational Remittance Form

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Congregational Remittance Form

Click here to 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 (NOTE ADDRESS CHANGE)
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 Campaign for the ELCA
Amount to Lutheran Disaster Response - U.S. only
Amount to Lutheran Disaster Response - International
Amount to World Hunger
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 Benevolence Fund for the Bishop
Amount to Benevolence Fund for the Bishop's Associate
Amount to Benevolence Fund for the DEM
Amount to Briarwood Retreat Center
Amount to Campus Ministry Fund
Amount to Fund for Leaders
Amount to Lutheran Seminary Program in the Southwest
Amount to Lutheran Sunset Ministries
Amount to Mission Congregation Support
Designation for Mission Congregation Support
If you would like to designate a particular NT-NL Mission Start
Amount to Mission Endowment Fund
Amount to MOSAIC offices serving our Synod
Mosaic is a faith-based organization serving people with intellectual disabilities.
If you would like to specify which MOSAIC office
Amount to Sierra Leone - Disaster Relief
Amount to Sierra Leone - General
Amount to Upbring
(formerly Lutheran Social Services of the South)
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.