NDC Online PAW Church Assessment Form

Date Submitting Form *

Month Day Year

Church Name *

Church Address *

Church Street Address

Church Street Address Line 2

Church City Church State / Province

Church Postal / Zip Code Country

Church # *

Area Code Phone Number

Church FAX #

Area Code Phone Number

Pastor's Name *

Pastor's Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

My Products

Church Size 1-49 ($50 + 3% Online Processing Fee) $ 52.00

# of months

Church Size 50-99 ($125 + $5 Online Processing Fee) $ 130.00

# of Months

Church Size 100-249 ($210 + $9 Online Processing Fee) $ 219.00

# of Months

Church Size 250-499 ( $420 + $17 Online Processing Fee) $ 437.00

# of months

Church Size 500-999 ($835 + $34 Online Processing Fee) $ 869.00

# of Months

Church Size 1000-1499 ($1250 + $50 Online Processing Fee) $ 1,300.00

# of Months

Church Size 1500-2999 ( $1735 + $70 Online Processing Fee) $ 1,805.00

# of months

Church Size 3000-4999 ( $2170 + $87 online Processing Fee) $ 2,257.00

# of Months

Church Size 5000 and above ($2600 + $105 Online Processing Fee) $ 2,705.00

# of months

Total $ 0.00