SPECIAL CONNECTIONS

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SPECIAL CONNECTIONS

Please fill out the form below if you would like more information about the Special Connections Ministry at Patterson Park Church

Name of person completing form. *

I am ... (check all that apply) *

a parent of a child with a disability

an individual with a disability

interested in serving/volunteering (see below at COACH question)

other

Required

If you have a child with a disability. Please type their name here.

What is the age and/or grade of your child?

Please present a basic description of specific needs and assistance your child would need at church.

We would like our child to participate in one or more of the following.

SC:Kids (3yrs - 5th grade) Sunday mornings 10:30am

Awana/Mini-Trek (3yrs - 5th grade) Wednesday evenings

SC:Adults (teens-adults) Sunday mornings 10:30am

Trek for teen-adults

I am interested inclusion classes on Sundays and Wednesday.

I am interested in helping with BLAST:Special Events

Other:

I am interested in serving/volunteering with Special Connections at one or more of the following times. (check all that apply)

Sunday mornings

Wednesday evenings

Special events

Not applicable

COACH: I would prefer to work with the following age groups,

Children (3years - 11years)

Teens & Adults

Either/Both/where ever the need is greatest

Clear selection

The best way to contact me is

Call

Text

Clear selection

In case of emergency, contact (include name, phone (xxx-xxx-xxxx) and email).

The best time to contact me is

morning

afternoon

evening

Clear selection

My email address is:

My phone number is:

What interested you in serving in this ministry (Please include if you are a college student needing ministry minutes)?

Submit

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