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Todays Date: Your name: Address: City: State: Zip Code: Home phone number: Cell phone number: Email address: Is this your 1st visit to our website? Yes No Not Sure Which Subject would you like more information on? Counseling Becoming a member Donating to the food bank Craft Classes Would you like a home visit from the pastor? Yes No Not sure Maybe Prayer Request Would you like this prayer request printed in the Prayer List Bulletin? Yes, Please publish my prayer request No, I would prefer to keep my prayer request private Any comments?
Yes No Not Sure
Counseling Becoming a member Donating to the food bank Craft Classes
Would you like a home visit from the pastor? Yes No Not sure Maybe
Yes No Not sure Maybe
Prayer Request Would you like this prayer request printed in the Prayer List Bulletin? Yes, Please publish my prayer request No, I would prefer to keep my prayer request private
Yes, Please publish my prayer request No, I would prefer to keep my prayer request private
Any comments?
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