If you would like to recognize a Centenarian, an individual 100 years or older, fill out the registration form below. 

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Prefer to download the registration form and submit via other options?

Mail your registration form to:

Dr. Jodi Southerland

Of One Accord Ministry

PO Box 207

Rogersville, TN 37857

Email your registration form to:

centuryclubNETN@gmail.com

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