JPC-LREDA Annual Enrollment 2021-2022
Please complete this form annually by October 1 in order to review meeting and member rosters. Note that you must also be a member of LREDA Continental to join JPC-LREDA. Please complete this form if you are in the process of applying to LREDA Continental or have already paid your LREDA Continental Dues.

IF YOU WISH TO APPLY FOR A DUES WAIVER or REDUCTION, please fill out this form in addition 
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Email *
First Name *
Last Name *
Which cluster are you applying to? *
Congregation Name and City, State *
Your role in the Congregation
Preferred Mailing Address, include city, state and full zip- code *
Preferred E-mail Address for Communication *
May we publish this information for our JPC-LREDA members? *
Preferred phone number to contact you. *
Alternate Phone
Number of Children/Youth in Your Program *
Would you like to learn about childcare for meetings (post COVID-19)?
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What Renaissance Modules have you taken?
Dues *
Donations: Please note the amount you are donating to our scholarship fund and add to the total of your check. Thank you!
What is the total amount (Dues + Donations if applicable)? Be sure your check is Payable to JPCLREDA.  A Paypal option is also available. *
When will you send your payment? *
Please send your check to: Andrea Lerner, JPC-LREDA Administrator, 1507 Windmill Ln, Breinigsville PA 18031  OR send via PayPal
A copy of your responses will be emailed to the address you provided.
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