Community Baptist Church of Greater Milwaukee
CBC Van Transportation Request Form (rev 2.8.16)
Please fill out and submit by Noon on Friday (Church office is closed Saturday & Sunday)
page 1 of 1
Please fill out all areas of this form to sign up for our van service. You can also call the church office, 414-445-1610 by Noon on Friday, to sign up or if you are in need of more information. If you have more than 5 individuals needing this service, please call the church office for more information.
Name *
required
First Name
Last Name
Address *
Address
Address Line 2
---------
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Marshall Islands
Micronesia
Northern Marianas
Palau
Puerto Rico
Trust Territories
Virgin Islands
Armed Forces(AA)
Armed Forces(AE)
Armed Forces(AP)
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territory
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
City
State
Zip Code
Phone *
required
Phone Number
Choose the service you will need transportation to and from *
select one
Select from list
select one
Sunday School & 10:30 a.m. Worship (NOTE: 1st Sundays, Sunday School starts at 8:00 a.m.)
10:30 a.m. Worship (NOTE: 1st Sundays, Worship starts at 9:00 a.m.)
How many individuals will need the service? *
select one
Select from list
select one
1
2
3
4
5
* required