English Español 한국어 English Clergy Gathering Registration Question Title * 1. Please enter your contact information: Name * Church * Address * Address 2 City/Town * State/Province * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code * Email Address * Phone Number * Question Title * 2. What is your gender? Female Male Question Title * 3. What is your birthdate? Date / Time Date Question Title * 4. Which of the following best describes your current relationship status? Married Widowed Divorced Separated Single, never married Question Title * 5. Which of the following group(s) do you fall into? White/Caucasian Black, African American, African American Indian or Alaskan/Arctic Native Arabic/Middle Eastern Asian Hispanic or Latino/Latina/Latinx Indigenous or Aboriginal Person Native Hawaiian or Pacific Islander Other (please specify) Question Title * 6. What is your ethnicity? Question Title * 7. Which Clergy Gathering will you attend? Monday, October 24th at Maranatha Church of the Nazarene in Paramus, NJ @ 6:30 PM Tuesday, October 25th at Springfield Gardens Church of the Nazarene in Queens, NY @ 6:30 PM Tuesday, November 1st at Primera Iglesia Del Nazareno in Stamford, CT @ 6:30 PM Done
