Power Sunday Registration Form

Fill out the information below and click Submit to register for Power Sunday on May 3, 2009. 

* Required fields
* Church Name:
Congregations will receive Power Pledge Cards (100 per pack; for all adults).
Please check the number of packs needed: 1 2
In addition to the Power Pledge Cards, you may choose one of the following.
Power Family Tree (100 per pack, limit 2 please)
Please check the number of packs needed. 1 2
Power Stroke Risk Assess. Survey (50 per pack; limit 4 please)
Please check the number of packs needed. 1 2 3 4
Physical Address:
Address Line 2:
City:
State:
Zip:
 
  
Contact Name:
Address:
Address Line 2:
City:
State
Zip:
* Phone:
* Email:

 
 


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Links on This Site
South Central Affiliate Cultural Health Initiatives

Power To End Stroke

Become A Power To End Stroke Ambassador

Power Sunday Downloadable Toolkit


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Power Sunday Registration Form


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