Ministry Contact Information Form Ministry personnel should complete and submit this form so that their contact information can be added to the Active Directory for ROLCM. Please keep your contact information up-to-date by completing this form once again if your information changes. Your Name(Required) First Last Your Primary Ministry(Required)ChosenCouples MinistryDeaconess MinistryDrama MinistryEvangelism MinistryFruit of Their HandsHealth and HealingHelps MinistryInformation Technology MinistryIntercessory PrayerMen's FellowshipMinisterial ServicesMinistry of MovementMinistry of ShalomMultimedia MinistryMusic MinistryNew Members Reception CommitteeNursery and ToddlersParking MinistryPuppet MinistrySafety and SecuritySeniors MinistrySingles Ministry (FOCUS)SPLASHTabernacle MinistryTeen MinistryUshers MinistryWomen of Wisdom (WOW)Are you the Ministry Head?(Required) Yes No Are you a member of any other ministries?(Required) Yes No Your Additional MinistriesPlease select all additional ministries. If you serve as Ministry Head for any other ministries, please make a note of that in the Additional Comments section below. Chosen Couples Ministry Deaconess Ministry Drama Ministry Evangelism Ministry Fruit of Their Hands Health and Healing Helps Ministry Information Technology Ministry Intercessory Prayer Men's Fellowship Ministerial Services Ministry of Movement Ministry of Shalom Multimedia Ministry Music Ministry New Members Reception Committee Nursery and Toddlers Parking Ministry Puppet Ministry Safety and Security Seniors Ministry Singles Ministry (FOCUS) SPLASH Tabernacle Ministry Teen Ministry Ushers Ministry Women of Wisdom (WOW) Your Personal Email Address(Required)This will be used to contact you or to set up your ROLCM account if you require a licensed account. Email Address Confirm Email Address Your Phone(Required)Your AddressThis is not required, but it is highly recommended that this information be included. Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Additional InformationFeel free to add any additional information that you think may be helpful. 94202