| First Name |
|
| Last Name |
|
| Street
Address |
|
| Address
(cont.) |
|
| City |
|
| State/Province |
|
| Zip/Postal
Code |
|
| Home Phone |
|
| E-mail |
|
|
|
|
Send me a Camper Registration form
|
|
Send me a summer Junior Staff
Application |
|
Send me Missionary Service Info &
Application |
|
I would like to receive the KMM
newsletter |
|
Contact me about support
opportunities |
|
Contact me about work group
opportunities |
|
Send me an "Instrument of Worship" CD ($12
donation) |
|
Send me an "On Wings of Faith" book ($12
donation) |
| Comments: |
|