In order to serve and support you, please fill out this short form.
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Name:
Email:
Comment:
Email Address
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First Name
Last Name
The church/charge I currently serve is:
If you are retired, just note that in the box.
I am a:
Local Pastor
Associate Member
Elder
Retired
Other
I am currently serving in the following district
Altoona
Harrisburg
Lewisburg
Scranton/Wilkes-Barre
State College
Williamsport
York
