Birmingham Emmaus Community: To Serve Form

Name

FirstLast

Male
Female

Address

Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry

Email

Phone

Church

Pastor

Walk Number

Community

Date

Are you presently in a reunion group, prayer group, study group or other support group?

Yes
No

Have you attended any Emmaus training sessions? If yes, in what areas of service

Are you interested in serving in some capacity in the Birmingham Emmaus Community? If so, please look over the following categories and select your area(s) of interest

Other Areas Music

Voice
Piano
Guitar
Other Music Service

Other Areas

Other

Check here if you have no preference and would like to serve wherever there is a need