Empowerment Month Host Registration
Thank you for your interest in becoming an Empowerment Month Host!
Name of Host
Location of Empowerment gathering
Please use full address
Date and time of Empowerment Gathering
Please note that we can only do two locations per day due to limited staff. If your date has already been chosen more than twice we will contact you to choose a new date. Please only choose a date in the month of September.
Will you need Vista Maria to provide food for your guests?
Yes, please send a Breakfast/Happy Hour package to my home
No, I will be providing the food
What program are you most interested in learning about during your presentation?
Shepherd Hall Transitional Living Program
Human Trafficking/ Our New Freedom Center
No Specific program
Please list your guest and potential guest names. You can go back into your registration and update this list at any time.
How many guests do you predict you will have?
Are you also interested in becoming a sponsor of Empowerment Month?
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service