Empowerment Weekend Electronic Registration Form
We thank you for your interest in participating in our annual Empowerment Weekend happening November 21 -22, 2015! This is a weekend where we bring services from community-based and other organizations to directly serve the needs of the congregation of your house of worship via an informational table and on-site professional to provide initial assistance. Bridge Street Development Corporation's history of being birthed out of Bridge Street AWME 20 years ago continues to drive the mission of our faith-based initiative to serve houses of worship just like yours!

As an incentive for registering your faith-based institution for Empowerment Weekend, the institution will also receive FREE financial counseling assistance provided by Prudential Financial Services
Name of House of Worship *
Your answer
Primary Contact/Title *
This person while be the onsite point of contact the day of the event
Your answer
Address *
Enter your full address including City & zip code
Your answer
Telephone # *
Your answer
Email Address *
Your answer
Cell Phone # *
Your answer
Fax *
Your answer
What day of the weekend do you offer communal service? *
Please indicate the time of the service with the greatest attendance *
Your answer
Please select congregation size *
I would like to help promote Empowerment Weekend to my congregation by displaying promotional materials *
If yes, which materials should we provide you with?
My congregation is in need of services in the following areas: *
Select the top 3 needs your members need information on - you will receive a call identifying priority
Required
I have volunteers that could assist with the processes of Empowerment Weekend *
Empowerment Weekend is a weekend that takes the help of many and we would love to build a volunteer relationship with your institution! We will have training the week of Empowerment Weekend to prepare volunteers to assist in the planning, organization, and implementation of Empowerment Weekend. We see volunteers as the bridge that closes the gaps faith-based institutions and organizations like Bridge Street Development in building an authentic, collaborative, and transparent engagement. Participating faith-based institutions MUST supply (2) volunteers in assisting with Empowerment Weekend.
Who are the volunteers that you will be providing for Empowerment Weekend? *
Please provide name and most convenient contact information including phone number and/or email address
Your answer
May we contact them? *
Agreement *
On-site professionals are expected to arrive one hour prior to your service either on Saturday, November 21st or Sunday November 22nd to set up informational tables. The house of worship will keep their house of worship open and staffed adequately at all times during the event. The participating house of worship agrees to abide by all applicable laws, ordinances, and regulations pertaining to health, fire prevention, public safety, and business licenses. The event will take place rain or shine. In the event that the event is cancelled due to weather or causes not within our control, you release on-site professionals and BSDC from all claims, damages, or loss
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