Shower Van - Request
Fill in the form below to request the SHOWERS of Blessings Van. You will be contacted for a final confirmation for your request after form is submitted.
* Required
Date of your Event
*
MM
/
DD
/
YYYY
Staring TIME of event?
*
Time
:
AM
PM
Church's Name or Organization
*
Your answer
Name of the Church's Pastor
Your answer
Name of the individual requesting the Van
*
Your answer
Position
Your answer
Email
*
Your answer
Phone
*
Your answer
Do you have any questions or comments?
Your answer
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