I am interested in the following services: 

	Please add me and/or my incarcerated loved one to your FREE quarterly mailing list (include additional address in comment space below)
	I am interested in your At-Risk Mentoring Group
	Add my loved one to your prayer list that is listed in your quarterly newsletter
	Drop my name in the prayer box at Pilgrim Rest Missionary Baptist Church for intercessory prayer.
	I would like to receive your weekly Bible studies via email.
	Other needs are specified below.
	Contact me regarding worship services at Pilgrim Rest Missionary Baptist Church.
	I live in your local community and am sick and/or shut-in.

Enter your comments or necessary mailing address of your loved one in the space provided below:

Tell us how to get in touch with you:

Name
E-mail
Phone
Address
City, State, Zip