JHT Pick-up Form
Please fill out this form and click submit.
Personal Information
Name
*
Email
*
This address will receive a confirmation email
Phone
*
Home Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Transportation Category
*
Please select one option.
Rider
Pick-up Details
Pick-up Location
*
Please select one option.
Home
Work
Flexible
Select Option
Home
Work
Flexible
If Flexible, specify preferred intersection or location
Total number of seat to be reserved
*
Pick-up Frequency
*
Please select all that apply.
Every Sunday
Every first sunday of the month
Every Bible study on Tuesday
Every Night vigil as specified in church
Submit
Description
Please fill out this form and click submit.
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