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First Name *

Last Name *

City *

State (Province) *

Phone *

Do you enjoy speaking in front of others? *

Yes

Would you prefer to be "behind the scenes"? *

Yes

Would you be willing to travel (you would be responsible for your own transportation)? *

Yes

Yes, but only locally

Would you be interested in organizing a mission trip to visit children? *

Yes

Would you be interested in organizing a Together Drive? *

Yes

Would you be interested in organizing a Gift Pack Drive? *

Yes

Church affiliation:

Are there other ways you would like to get involved? Explain.

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This form was created inside of Lifeline Christian Mission.