Partners in Ministry Form

Remember when your are the boss, your name is on the door.

Get your business online today and create your economy.

Complete the following form for the Partners in Ministry Program at Queen of Peace:

Complete information for Partners in Ministry

Please note that all fields followed by an asterisk must be filled in.

Join Business Partners in Ministry Program?

	Yes
	No

Choose your business category

Business Name*
Business Name*

Business Address*
Business Address*

City*
City*

State/Prov*
State/Prov*

Zip/Postal Code*
Zip/Postal Code*

Business Phone*
Business Phone*

First Name*
First Name*

Last Name*
Last Name*

E-mail Address

Web Site URL

Fax

Home Phone

Hours of Operation

Days of Operation

Suggested Headline for Web Page*
Suggested Headline for Web Page*

Business Description*
Business Description*

Phone number if you it want on web page (include area code)

Please enter the word that you see below.

Click here to return to the Partners in Ministry page