Indiana Clergy Organizing
Use this form to keep track of the growing interest in faith based community organizing amongst Clergy in Indiana!
Referred by (Person who gave you this name)
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First Name *
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Last Name
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Congregation *
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CELL PHONE
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Email
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ADDRESS
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CITY
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ZIP
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Website
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Outreach Priority
Background. Includes: Relationship with others, denominational role, reason for referral, demographics of congregation or community
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One to One Visit: Notes
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SUBMITTED BY (YOUR NAME HERE) *
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