CHURCH REPRESENTATIVES

We are looking for women who would like to become Change Life church representatives. If you are interested and willing to make the commitment, please fill in and submit the following form

Yes. I am interested in becoming a church representative
Yes. I would like to sign up to bring muffins to the seminar
     
Name:
 *
E-mail:
 *
Address:
City:
 
State:
  Zip: 
Phone:
  
Fax:
Home Church:  
Comments:

 
  
 
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