Half-Day Workshop Registration Form
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Contact Name:_____________________________________________________________
Address:_____________________________________________________Zip:__________
Phone:__________________________Church:__________________________________
Number
Attending:___________
Amount: $____________
Please provide list of Additional Attendees' Names
Check Segment Attending: ___ Bereavement
___ Ministry to the Sick
___
Funeral Ministry ___ Leadership Workshop
Please mail the completed form to:
Samaritan Ministry, Inc.
14811
St. Mary's Ln., #138
Houston, TX 77079
or FAX the form to: 281-589-0520