Reimbursement of $100 of registration cost will be provided for your congregation’s elected president/lay leader (i.e., Congregational President, Moderator, Board President, Prudential Chair, or President-Elect [President in 2014-15]). We regret that reimbursement cannot be provided for staff, professional leaders (ministers, administrators, DREs) or elected officers other than those listed. Only one reimbursement per congregation will be issued; subsidy is limited to 500 reimbursements or $50,000.

Question Title

* 1. Please provide your six digit registration ID. This six digit number can be found in the bottom right hand corner of your registration confirmation. It is also the last six digits of the number printed under the bar code on your GA name badge. For example, if it says 1234-567890 beneath the bar code on your name badge, your registration ID is 567890.

Question Title

* 2. First Name

Question Title

* 3. Last Name

Question Title

* 4. Email address

Question Title

* 5. Position in the congregation

Question Title

* 6. Congregation Name

Question Title

* 7. Congregation City

Question Title

* 8. Congregation State

Question Title

* 9. Whom are requesting a rebate check for?

Question Title

* 10. Payee for rebate check:

Question Title

* 11. Address line 1

Question Title

* 12. Address line 2

Question Title

* 13. City

Question Title

* 14. State/Province

Question Title

* 15. Zip Code

This rebate form will be available until July 15. Rebate checks will be issued and mailed in late July. If your rebate check does not arrive by August 10, please contact the General Assembly Office at generalassembly@uua.org.

T