WELS Prison Ministry Referral Complete this referral form to provide contact information for yourself or someone else to receive ministry in one of the areas of ministry indicated. A field marked with a red asterisk * is required.Change requestAre you reporting an update to previously submitted information? Check box if you are requesting an update to information already submitted. Other Special Ministries Referrals WELS Special Ministries provides resources and guidance for people who face barriers such as disabilities (hearing loss, intellectual or developmental disabilities, mental health issues or other challenges). If you know someone who is experiencing a barrier to participating in worship or other church life, you can ask questions or tell us about this person's needs by using the Contact Us form. Is the person you are referring an European Union (EU) resident?* Yes No We are not able to send materials to European Union (EU) residents without their expressed permission according to the European Union's General Data Protection Regulation (GDPR). EU residents may request our materials directly by contacting WELS via our Contact Us form. Complete the following fields for WELS Prison MinistryInmate name* First Last GenderSelect oneMaleFemaleMarital statusSelect oneSingleMarriedDivorcedWidowedInmate address*Inmate ID number WELS Special Ministries assists local congregations in serving their members and wishes to keep the church informed of our contacts with their members. Please provide information regarding the church of which this person is a member, if any.Church namePastor's nameCityState/ProvinceSelect oneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonE-mail of person submitting the form* Other informationData Privacy & Permission* I AGREE with the terms of the WELS Privacy Policy.NOTE TO EU CITIZENS, RESIDENTS, TOURISTS, AND OTHER PERSONS TEMPORARILY IN THE EU: By submitting this form you consent to any and all information you provide and submit via the site being sent to the United States of America. The United States has not sought nor received a finding of “adequacy” from the European Union under Article 45 of the GDPR. WELS relies on derogations for specific situations as set forth in Article 49 of the GDPR. You are also informed that the United States presently does not have an adequate level of personal data protection as determined by the European Commission’s adequacy decision on October 6, 2015 (case c-362/14) and articulated in the European Union’s General Data Protection Regulation and has not received a similar designation of adequacy by any other foreign data protection authority. You agree to the transfer of your data and personal data to the United States, however, to be used in accordance with WELS Privacy Policy. Δ WELS Help Desk: [email protected] or 414-259-4357 | Privacy policyRef: WELS Special Ministry Referral Form