Payment Request Form

Today's Date *

Event Date *

Event Title *

Requested By *

Your Phone Number *

Date Needed *

Email *

Phone *

Ministry Group *Music and Fine ArtsService SupportCulinary ArtsChristian EducationCongregational CareOutreach MinistryFamily Life (Adult)Family Life (Youth)Ecumenical OrderMembershipFellowship

Ministry PastorPastor Chandra KeithPastor Chris TurnerPastor Debra JonesPastor Monica McDowellPastor Denise PitchfordPastor Jessie GriffinPastor Curtis Neal Pastor Estelle Cockroft

Select form of payment *CheckCash ($50 limit)Credit Card

Amount Requested *

Make Check Payable to: *

Reason for Payment Request *

Has your COD approved this request? *

• Yes
• No

Has your Pastor approved this request? *

• Yes
• No

Phone

Submit