Members – Westhills Church

Name *

First

Last Name *

Last

Email

Please Provide a Phone Number and Confirm it in the Second Box

Confirm Please Provide a Phone Number and Confirm it in the Second Box

What can we help you with today?

Notify Us of a Change of Address

Pastoral Care for Me

Pastoral Care for Someone Else

Please Tell Us Your Current Address

City

State/Province

Zip/Postal

Please Tell us Your New Address

City

State/Province

Zip/Postal

Please Tell Us Your New Phone Number

Confirm Please Tell Us Your New Phone Number

Please Tell Us Your Email Address

Confirm Please Tell Us Your Email Address

Tell us a little bit about what’s happening with you…

Tell us who you’d like to have respond to your concerns. An Elder may still make first contact with you

My Elder or Pastoral Care Coordinator

My Minister

N.B.

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Yes. They have given consent

No, I do not have their consent

Tell us what your concerns are for someone else. We’ll treat it in absolute confidence *

Can you tell us the name of the person you are concerned for?

First Name

Last Name

Can you tell us where this person lives?

City

State/Province

Zip/Postal

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I consent to having this website store my submitted information so they can respond to my inquiry.