Donation – New England Pentecostal

Date *

Department Information

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Department Name *

Person Requesting Funds

Title

Telephone #:

Check Distribution Information

Payee Name *

First

Last

Address

Address Line 1

City

State

Zip Code

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Telephone #

Payment Due Date

Amount Requested *

Memo

Upload Invoice/Receipt (if available)

Click or drag a file to this area to upload.

No payments can be disbursed without proper invoices, receipts or authorization for reimbursements. (Please attach invoices or receipts to this request)

Name *

First

Last

Address

Address Line 1

City

State

Zip Code

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Email *

Phone *

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Dates Desired 1 (4th Sundays Only) *

Dates Desired 2 (4th Sundays Only)

Please check appropriate response:

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Member

Related to a member

Child's Information

Child's Name as it appears on Birth Certificate (Please provide us with a copy)

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Place of Birth

Child's Gender

Hospital

Date of Birth

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Parent's Name

Godparent's Name

Upload Birth Certificate *

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IF YOU ARE NOT A MEMBER OR A RELATIVE OF A MEMBER HERE AT THE NEW ENGLAND PENTACOSTAL MINISTRIES, THEN THERE IS A PROCESS FEE OF $35.00.

Name *

First

Last

Address

Address Line 1

City

State

Zip Code

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Tele/Cell (public) *

Names of Children

Email *

Birthday *

Did you hold a membership at a previous church?

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Have you been called to the ministry?

Were you working in the ministry prior to coming here?

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Do you desire to work in this ministry?

Date of class to attend

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Signature

Clear Signature

Date

DONATE FOR A CAUSE

OTHER DONATION METHOD

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CHECK REQUEST FORM

Department Information

Check Distribution Information

Birth & Dedication Application

Child's Information

New England Pentecostal Ministries Membership Request Application

Baptism Sign Up