Member/Guest Care Request Form

Get in touch

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mymail@mailservice.com

MEMBER CONTACT

CHURCH CALENDAR

Date

First Name

Last Name

Cell / Home Phone

Work Phone

Preferred contact method

Cell/Home

Work

Best Contact Time

May we leave a message for you?

Yes

MEMBER?

YES

If yes, what is the name of your Deacon?

If yes, have you contacted your Deacon?

YES

If so, when?

New Field:

Reason for contact: (Check all that apply) Dark red banner with white text:

Salvation, Rededication or Membership information

Death In Family

Prayer

Counseling

Human Services Resources (food, clothing, shelter etc.)

Seeking information about Church ministry or Church resources

Other(please provide details below):

Message:

Thank you for contacting us.
We will get back to you as soon as possible.

Oops, there was an error sending your message.
Please try again later.

STREET: 230 ½ South 51st Street Philadelphia PA 19139-4176 MAIL : P.O. Box 19177 Phila., PA 19143-0177 PHONE: 1-888-GOD'S JOY or (215) 472-9551

FAX: (215) 472-1397 EMAIL: PHILAPRAYER@gmail.com FACEBOOK TWITTER YouTube Channel PODCAST

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