Registration Form
Print this form out and mail along with payment to:
Singles Support Group "Together"
c/o Susan Malone
7195 S. Shields Ridge Road
Bloomington, IN 47401
Back to Bethany 2002 Registration Form:
Name:
Address:
City:
Zip/Post. code:
State/Prov:
Phone:
E-mail:
Sanders Pentecostal Church (UPCI)
6490 S. Fairfax Road
Bloomington, IN 47401
Pastor Joe Nelson
Phone (812) 824-9888
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Registration Form
To contact us:
Phone: (812) 824-4610
Email: Susan Malone, Director
