NC East District Minister Address Information

Name

Address

Birth date & Anniversary

Phone Numbers:

NoWe will not print cell phone number unless you request it. Print cell phone number

Home email

Church Address

Church Numbers

Church Email

Send email to church or home

If associate or assistant pastor:

At which address do you wish to receive your mail

If other give address:

Ministerial Student: (home address above; mailing address at school here)

Phone at school if different than above

At which address do you wish to receive mail:

Name of Person Filling Out Form:*

Email of Person Filling out Form:*

Also send me a copy

*Required