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 AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific 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 NumberPlease 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 DesignationsAmount to Campaign for the ELCAAmount to Lutheran Disaster Response - U.S. onlyAmount to Lutheran Disaster Response - InternationalAmount to World HungerAmount to ELCA OtherDesignation 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 DesignationsAmount to Benevolence Fund for the BishopAmount to Benevolence Fund for the Bishop's AssociateAmount to Benevolence Fund for the DEMAmount to Briarwood Retreat CenterAmount to Campus Ministry FundAmount to Fund for LeadersAmount to Lutheran Seminary Program in the SouthwestAmount to Lutheran Sunset MinistriesAmount to Mission Congregation SupportDesignation for Mission Congregation SupportIf you would like to designate a particular NT-NL Mission StartAmount to Mission Endowment FundAmount to MOSAIC offices serving our SynodMosaic is a faith-based organization serving people with intellectual disabilities.If you would like to specify which MOSAIC officeAmount to Sierra Leone - Disaster ReliefAmount to Sierra Leone - GeneralAmount to Upbring(formerly Lutheran Social Services of the South)Amount to NT-NL OtherDesignation 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.