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CONVERGEWORLDWIDE (BGC) - 2nd 1/2 for Him Ministries.
Expanded survey and Mailing list information.

This information will be forwarded to Richard & Leona Bergstrom, Coordinators for 2nd 1/2 for Him Ministry. It will be used to update your contact information solely within the Baptist General Conference and not be shared with 3rd parties.

If you would like to be on the national 2nd 1/2 4 Him Mailing list, please take a moment to fill out the information below. If you would ONLY like to receive email, then go back to the subscription link for 2nd Half for Him e-news.

[NOTE: Fields with an asterisk* are required. The form will not submit without them completed. Push submit button at bottom when done.]


Title: (Mr., Mrs., Miss, Ms., Rev., Dr. etc)
*First Name:
*Last Name:
Home Church or Organization represented:
Position (If on church or organization's staff)
*Mailing Address:
*City:
*State:
*ZIP:
Work Phone
Home Phone:
Fax:
Email (if any):
Website (if any)

The above mailing address is my (check only one):
Work Address
Home Address

AGE GROUPING (Optional)
50-64 years old
65-79 years old
80+ years old

*INDICATE YOUR ROLE IN AGE 50+ / SENIORS MINISTRIES
(check only one)
I'm the "District Champion" for 2nd 1/2 4 Him Ministries in our District.
I'm the (senior) pastor and we have no staff or lay volunteers ministering in this area.
I'm the (senior) pastor and I supervise staff or lay volunteers ministering in this area.
I'm a staff person with a responsibilities in age 50+ / seniors ministries.
I'm a volunteer leader in my church responsible for age 50+ / seniors ministry.
I'm a lay volunteer serving on a committee or team in my church's age 50+ / seniors ministry.
I'm a participant in age 50+ / seniors ministry.

COMMENTS:

*INDICATE PREFERRED METHOD OF CONTACT WITH YOU (check only one)
E-Mail!
USPS Mail
Telephone

Check the NO button if you would prefer not to be added to our mailing list
YES, Please add my email to your mailing list for BGC 2nd 1/2 4 Him
NO, do not add my name to your mailing list for BGC 2nd 1/2 4 Him

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Click the Submit Button only once to avoid duplicate submissions.