Please print this page as confirmation of the details you provided on the previous page. If information is incorrect, please return to the form as noted below and resubmit data.
Transaction finalized upon approval of credit card information.
Your registration will be confirmed by e-mail when we have received credit card information via telephone (717.545.4761; Monday-Friday, 9 a.m.- 4 p.m.).
Printing Invoice #: Printing#
Printing Invoice Amount: $PrintingAmt
Office Rent Invoice #: Rent#
Office Rent Amount: $RentAmt
Mailing Address: Address
City: City State: State Zip: Zip
Telephone #: Phone
Cell #: Cell Phone
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Pennsylvania Council of Churches 900 S. Arlington Avenue, Suite 211A, Harrisburg, PA 17109-5024
Telephone 717.545.4761 Facsimile 717.545.4765 E-mail email@example.com
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