2019 Pastor and Wives Dinner If you are human, leave this field blank. Pastor information First Name * Last Name * Email Address * Phone Number * Church Address * Church Address Church Address Church Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Will/will not be attending Will be attending (complete the rest of the form) Unable to attend (please consider the opportunity for next year!) Allergy concerns Food, Latex, etc. Will spouse be attending? Yes No Spouse Information First Name How would you like to pay * Pay at the door Drop in the mail Payment can be mailed to Grace Church, POB 2336, Oak Ridge, NJ 07438 Submit
