Application for Retirement Status
First Name
*
Last Name
*
Primary Email Address
*
Primary Phone
*
New Home Address
Mailing Address
Mailing City
Mailing State
Mailing Zip Code
Congregation You Plan on Joining
Congregation Membership
Alleluia!, Naperville
Alpine, Rockford
All Saints, Byron
Augustana, Andover
Becoming, Oswego
Bethany, Crystal Lake
Bethany, Leland
Bethany, Woodhull
Bethel, Stronghurst
Bethesda, Morrison
Bethlehem, DeKalb
Bethlehem, Joliet
Bethlehem, Rockford
Calvary, Moline
Calvary, New Windsor
Calvary, Rockford
Cambridge, Cambridge
Capron, Capron
Christ, Belvidere
Christ, Stockton
Cross & Crown, Roscoe
Cross of Glory, Homer Glen
Emmanuel, Oregon
Emmanuel, Rockford
Emmaus, McNabb
Faith, Forreston
Faith, Joliet
Faith, Rochelle
Faith, South Beloit
Faith, Wataga
First, Chadwick
First, DeKalb
First, Freeport
First, Galesburg
First, Geneseo
First, Granville
First, Joliet
First, Lee
First, Moline
First, Monmouth
First, Mt Carroll
First, Ohio
First, Pecatonica
First, Plano
First, Prophetstown
First, Rockford
First, Rock Island
First, Sherrard
First, Sterling
Followers of Christ, Plainfield
Freedom, Oregon
Grace, Knoxville
Grace, Loves Park
Grace, Richmond
Grace, Wilmington
Grace, Woodstock
Good Shepherd, Lena
GPS, Machesney Park
Heart of Illinois Parish
Iglesia San Jose Obrero, Moline
Illinois River Valley Parish
Immanuel, Amboy
Immanuel, Compton
Immanuel, Dixon
Immanuel, Earlville
Immanuel, Marseilles
Immanuel, Peru
Immanuel, Rock Falls
Immanuel, Yorkville
Joliet, Bethlehem
Joyful Harvest, Johnsburg
Joyful Spirit, Bolingbrook
Light of Christ, Algonquin
Living Waters, Crystal Lake
Lord of Love, Galena
Lutheran Church of the Good Shepherd, Rockford
Messiah, Aledo
Messiah, Galesburg
Messiah, Galva
Messiah, Port Byron
Nativity, Wonder Lake
New Life, Bolingbrook
Our Savior's, Rockford
Our Savior's, Seneca
Our Saviour, Sandwich
Plattville, Minooka
Prince of Peace, Freeport
Peace, Morris
Peace, New Lenox
Peace, Port Byron
Redeemer, Kewanee
Redeemer, Woodstock
Resurrection, Channahon
Salem, Moline
Salem, Rockford
Salem, Sandwich
Salem, Sycamore
Santa Cruz, Joliet
Scenic Hills Parish
Shepherd of the Hill, Lockport
Shepherd of the Hills, McHenry
Shepherd of the Hills, Scales Mound
Shepherd of the Prairie, Huntley
Shepherd of the Valley, Rockford
St. Barnabas, Cary
St. James, Forreston
St. James, Rock Island
St. John's, Ashton
St. John's, Creston
St. John, Elizabeth
St. John's, Hebron
St. John, Joliet
St. John's, Mendota
St. John's, Pearl City
St. John's, Peru
St. John's, Princeton
St. John's, Rock Island
St. John's, Somonauk
St. John, Sterling
St. Mark, Rockford
St. Mark's, Polo
St. Matthew's, Princeton
St. Paul, Dixon
St. Paul, Hanover
St. Paul, Kent
St. Paul, Orion
St. Paul, Sterling
St. Paul, Streator
St. Paul's, Tonica
St. Paul's, Warren
Swedona, Lynn Center
Trinity, Durand
Trinity, Elizabeth
Trinity, Galesburg
Trinity, Harvard
Trinity, Lanark
Trinity, Manlius
Trinity, Milledgeville
Trinity, Moline
Trinity, Mt Morris
Trinity, Ottawa
Trinity, Rockford
United, Gardner
United, Rockford
Zion, Belvidere
Zion, Kewanee
Zion, North Henderson
Zion, Rockford
Other ELCA congregation outside the NIS
Other denomination
Northern Illinois Synod
Mosaic
Lutheran Social Services of Illinois
ELCA Director of Mission Support
Lutherdale
Portico Benefit Services
St. Olaf College
ELCA Foundation
Mission Investment
Official Date of Retirement
Date
*
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