Piercing Word


Piercing Word Referral Form
When you give us information about a church or group, we will reach out and connect with them by phone and email. We'll tell them all about Piercing Word and invite them to our next public performance so they can see what we do for themselves. Please know that by referring an organization, there is no obligation on their part, we will simply introduce our ministry to them.
Tell us about you!
First Name *
Last Name *
Email
Phone
Who do you think should see us?
Church or Group Name *
Address (if known)

City *
State *
Who's the best person to contact? (if known)
What is your relationship?
Contact Person's Phone # (if known)
Contact Person's Email (if known)
Other...
Notes (tell us more about this group and why we should connect with them!)

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