OTM Form

Opportunity To Minister Form (OTM Form)

* Indicates required field

Your Name *

First

Last

Your Email *

Name of Person in Need *

First

Last

Condition *

Hospital *

Hospital Room Number *

Date of Surgery, Test, Hospitalization... *

Membership Status *

Home Phone Number *

Cell Phone Number *

Cell Phone Number (Spouse) *

Spouse Name *

Names and Relationship to Others in the Church... *

Funeral Home *

Will Pastor Chris be Officiating? *

Unknown Yes No

Vistation Date and Times *

Service Date and Times *

Submit