Pastor
Contact Us
I. Personal Information
Male    Female
II. Contact Information:
Please check the preferred method.
Home Phone:

Cell Phone:

Cell Phone:

Email:
III. Meeting Days
Check all that applies

On a typical week, the best day(s) for me to attend a meeting is:
Thursday
Monday
Friday
Tuesday
Saturday
Wednesday
On a typical week, the best time of day for me to attend a meeting is:
IV. Food/Drink Preferences:
Please check items of your choice.  If your choice is not listed, please specify under "other".
Breakfast:
Cereal

Pancakes

Donuts
Dec. Coffee

Fruit Juice

Specialty Coffee
Muffins

Eggs

Fresh Fruit
Bagels

Biscuits

Yogurt
Orange
Juice
Reg.
Coffee
Milk
Lunch/Dinner:
American

Mexican

Italian:
Chinese
Coke

Diet Coke

Dr Pepper
Tea

Flavored Tea

Coffee
Root Beer

Diet Root
Beer

Sprite
Diet Dr
Pepper
Pepsi

Diet Pepsi
Sprite Zero

Orange

Grape
Water (non- carbonated)

Water (carbonated)
Snacks:
(Please fill in)
V. Special diets and/or food allergies
NO
YES
Thank you for your information!!!
Please press submit to finish.