MNLC Worship, Arts & Media Contact Form
Please complete the information below to be placed on the worship, arts & media distribution lists.

Rev. Dr. Tiffany Bennett-Cornelous
Pastor of Worship, Arts & Media
TCornelous@macedonianewlife.org
I am completing this form because: *
First Name of Participating Disciple(s) - list each name on a separate line *
Last Name of Participating Disciple(s) - list each name on a separate line *
Email Address 1 (if your child is a participant under the age of 18 and has not graduated from high school, please list the adult's email address) *
yourhandle@domain.ext
Email Address 2 (if desired)
Phone Number for receipt of text messages (no dashes please)
xxx123xxxx
Alternate Phone Number
Birthday (to be given encouragement on your special day)
June 26 - if more than one, list each on a separate line coinciding with the names above
Known medical conditions, allergies
Please check all areas within the worship, arts & media ministry of which you are a member or interested in becoming one.
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