| Congregation Name:* | |
| Contact Person, Title:* | |
| Phone Number:* | |
| E-mail:* | |
| Date(s) Requested:* | |
| Church Address:* | |
| We are part of the: | ELCA
LCMS
Unaffiliated Lutheran Church
Other
|
| Other: | |
| Indicate number of worship services and times: | |
| Total expected attendance, including all services: | |
| Are you also requesting a speaker for adult forum?: | Yes
No
|
| Adult forum start time, duration, and expected attendance: | |
| Special theme or focus for worship: | |
| Does your congregation have a special connection with Christians or a sister congregation in another country?: | |
| Other events occurring on the same day (Fair Trade sale, musical performance, after-church social event, etc): | |
| Is your congregation interested in taking a special offering that day to support LWR programs?: | Yes
No
|
| Is your congregation interested in sharing members’ contact information so LWR can stay in touch about our important ministry?: | Yes
No
|
| Which best describes your congregation?: | My congregation is new to LWR, and we’d like someone to come and tell us more about your work and how we can get involved
Someone from my congregation recently heard an LWR speaker at another event, and we want to bring that same inspirational message back to our congregation
My congregation has been involved with LWR in the past, but we’re interested in more ways to engage
My congregation is very familiar with LWR and we’d like to personally connect with a LWR staff member and share our stories
|
| Is your congregation a part of the Lutheran Malaria Initiative?: | Yes
No, but we’re interested in learning more and getting started
No, and we are not interested in LMI at this time
|
| What other ways does your congregation connect with LWR? (Select all that apply): | My congregation is a contributor to LWR’s Quilts and Kits Ministry
My congregation is passionate about Fair Trade, whether through the LWR Coffee Project, Divine Chocolate, Eco Palms, or Fair Trade Handcrafts sales
My congregation holds special offerings to raise money for disaster relief
Other
|
| Other: | |
| Are you able to cover travel costs?: | Yes
No
Partially
|
| Do you have a preferred speaker? |
LWR cannot guarantee the availability of a particular speaker, but will do our best to accommodate your needs and wishes. |
