NJC Van Request Form

Please complete the form below:

Today's Date	*
Title	*	Select Mr. Miss Mrs. Ms. Dr.
First Name	*
Last Name	*
Cell Number	*
Email Address	*
Name of Ministry	*	Select One Armor Bearer Associate Ministers Birthday Bookstore Boy Scouts Business & Marketing Champion Men Ministry Children (Elementary) Christian Education Counseling Couples in Faith CROWN Financial Ministries Custodians D.O.V.E.S Dance Deacons & Deacons' Wives Decor Edifice Building & Facilities Ministries Edifying and Training Ministries Elective Pastoral Ministries Evangelism & Mission Exalting Ministries Executive Business Family Enrichment & Support Finance Food and Clothing Forever Young Girl Scouts Girl Talk God’s Homeless Haven Grace Abounds Greeters Grounds Health Ministry Juniors (Middle School) Living Free Ministry Media Ministry Men of Honor Mime Mothers’ Ministry Music New Members NJ Christian School Nursery (Preschool) Office Orientation Parking Lot Power of Twelve Prayer Prison Recreation S.A.L.T. Senior Women Outreach Servant Ministry Shepherding Singles Sisters In Christ Straight Talk Sunday Bible Study Taste Kitchen The Harvest Food Ministry The MANNA Project Theatre Transportation Ushers Visitors Youth (High School) Other
Other
Number of Pessengers	*
Number of Vans	*
Est. Travel Miles (Round Trip)	*
Departure Date	*
Return Date	*
Drive No. 1
Title	*	Select Mr. Miss Mrs. Ms. Dr.
First Name	*
Last Name	*
Valid Driver Licence Number	*
Cell Number	*
Drive No. 2
Title		Select Mr. Miss Mrs. Ms. Dr.
First Name
Last Name
Valid Driver Licence Number
Cell Number
Gas Paid By:	*	Select One Ministry Leader Driver No. 1 Drive No. 2 Other
Other
Keys will be picked up by:	*	Select One Ministry Leader Driver No. 1 Drive No. 2 Other
Other
Keys will be returned by:	*	Select One Ministry Leader Driver No. 1 Drive No. 2 Other
Other