EmailMe Form - 180 Turn Around Drive - State Convention Offering

Your name *

First Last

Local Church *

Organization Name

If Other was selected for Local Church, please enter your organization name here

Your email address *

You will receive a confirmation of your registration form sent to this email address.

Individual Or Group Registration *

Are you registering for yourself or for a group?

Group Name

Permission To Share Your Name or Group *

YES

NO

May we share your name/group name to encourage others to give?

Amount Pledged *

$180

$360

$540

Other

OtherAmount

$ Dollars . Cents

Comments