Refresh Connect Request

WELCOME TO REFRESH!

Thank you for saying yes to receive Refresh email and mailings.

We’ll keep your information confidential and it will only be used for Southern Missouri District Office purposes and will never share your information with any other party.
Name*
Personal Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Personal Cell Phone*

Area CodePhone Number
Personal Home Phone

Area CodePhone Number
Personal E-mail Address*
Are you on Facebook?*

YesNo
What is your Facebook Name?
Spouse's Name, if applicable
Church You Attend*
Southern Missouri Ministry Network Area:
I am: (Check all that apply.)*

CertifiedLicensedOrdainedLead PastorMissionaryStaff PastorLead Pastor's WifeStaff Pastor's WifeMinister's WifeOther
I am interested in: (Check all that apply)

Connect Group: Virtual and Face-to-Face.Lunch & Learn (6 sessions)Connect Group: Female Youth Pastors.Connect Group: New to SOMO Network (Newly Credentialed/Transfers In)Other
I'm new to the Southern Missouri Ministry Network. I am interested in a one-time virtual connection to meet our SMMN leaders and to learn what each department has to offer.

Yes
I give Refresh Ministry Women permission to add me to their mailing list.*
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