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Adult Ministry Registration
*
Required
First Name
*
Last Name
*
Email Address
*
Address Line 1
*
Address Line 2
City
*
State
*
--
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FL
FM
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MH
MI
MN
MS
MO
MP
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VI
VT
VA
WA
WV
WI
WY
ZIP Code
*
Home Phone
*
(
)
-
ext.
Mobile Phone
*
(
)
-
ext.
Please check one:
Mr.
Mrs.
Ms.
Marital Status:
*
Single
Married
Divorced
Widowed
Engaged
I attend:
*
Hope
another church
no church affilitation
Age Group:
*
20-29
30-39
40-49
50-59
60+
I will need professional childcare provided for my child/ren:
*
Yes
No
Please indicate full name, birthdate and gender of each child needing care:
*
Name of Class (and section if applicable):
*
Day/time of class:
*
Please send me the following ministry e-newlsetters:
Men
Women
Small Group
Marriage and Parenting
50+
Singles
Applicable class/event fee(s) are payable before the first class (checks payable to Lutheran Church of Hope.)
Last Published: December 10, 2008 8:49 PM
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