SHECHEM MINISTRIES
A REFUGE FOR PREACHERS
APPLICATION*
IN A CRISIS, APPLICATION CAN BE COMPLETED ON THE PHONE. Call - Grant Mathes - Cell # 502-859-0359.
DATE______________
Name _________________________ Wife’s Name _________________
Total number of people that will be at Shechem? ____________________
Home Address______________________________________________
______________________________________________
Home Phone __________________Cell Phone ____________________
E- Mail Address __________ ______________
Date desiring to come____/____/____.
Time you will arrive _________(Eastern Standard Time)
Date you plan to depart ____/____/____.
Time you will depart____________(Eastern Standard Time)
Reason for visit: Crisis __ Time off___
Church __________________________
Active or Inactive position held______________________
Address ___________________________
___________________________
Church Phone # ________________________
Have you been to Shechem before? ____ When? ___________________
If you find you are going to be late arriving, please call:
Grant Mathes - Cell # 502-859-0359.
Please, have a good time, and God bless you!
*TO SUBMIT THIS APPLICATION, COPY AND PASTE BLANK APPLICATION TO: E-MAIL, complete and send e-mail.
All information about your stay will be held in confidence.
Mailing address: Shechem Ministries
% Grant Mathes
1587 Fairview Rd
Lawrenceburg, KY 40342
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