EMS APPLICATION
                                            United Methodist Men

Date________________________

My $30 is enclosed. 

Check___  Money Order___  Visa ___

Card No._________________________Expiration Date____________

First time Subscriber_____    Renewal Subscriber_____

Signature ________________________________________

Name_______________________________ Church________________________________

Address________________________________________             ______________________________________________

City, State,                  .                 .          
.  Zip Code_____________________________________                ______________________________________________
______________________________________________                ______________________________________________

Home Phone No.    (         ) _____________________  

Conference  .......... CAL-PAC                   District:  ..............Pasadena

Email__________________________________


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Mail to the General Commission on United Methodist Men
.          .        .P.O> Box 340006,  Nashville, TN, 37203-0006
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