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Nazarenemissions. org City State/Province Postal Code Daytime Phone Missionary Health Care of which Memorial Roll is a part is an Approved Mission Special. E-mail In US make check payable to General Treasurer Church of the Nazarene In Canada make cheque payable to Church of the Nazarene Canada Mail order form remittance form and check to Global Treasury Services PO Box 843116 Kansas City MO 64184-3116 20 Regan Rd Unit 9 Brampton ON L7A 1C3. Please circle name if honoree is 12 or younger. Mail Certi cate s to Name Address Use this form for ordering up to 8 certi cates. 75 per person Duplicate certi cates for honorees are available for an additional 25 per certi cate. NMI Memorial Roll Certi cate Order Form Type or Print Clearly Verify Spelling and Addresses Church District Name in full Church ID Number Please indicate if you prefer a certi cate in Spanish Portuguese Date of Presentation To be placed on certi cate Honorees Names Only one name per Memorial Roll certi cate. Please circle name if honoree is 12 or younger. Mail Certi cate s to Name Address Use this form for ordering up to 8 certi cates. 75 per person Duplicate certi cates for honorees are available for an additional 25 per certi cate. In the box following the name indicate the number of duplicates needed. Delivery Times Mail-in orders 3-5 weeks Online orders 5-10 business days www.

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