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.

* 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.

* 2. First Name

* 3. Last Name

* 4. Email address

* 5. Position in the congregation

* 6. Congregation Name

* 7. Congregation City

* 8. Congregation State

* 9. Whom are requesting a rebate check for?

* 10. Payee for rebate check:

* 11. Address line 1

* 12. Address line 2

* 13. City

* 14. State/Province

* 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