MCGN

Membership Form

MCGN MOTTO
TO SERVE OTHERS
The Son of Man did not come to be served, but to serve". (Mt. 20:28)

Complete Name:

Company Name:

Address:

State:

City:

Zip Code: -

Telephone Number:

Fax Number:

Email Address:

Occpation:

Age Group:

Willing to contribute service?

Typing Phone Calls Writing Giving

Prayer Making Copies Mailing Other

Signature____________________________________Date___________________

Rev:Dec98

Complete, print and send form with check payable to:

3400 Angel Lane
Placerville, CA 95667