"Estamos Listos--We Are Ready" Sign Up
RequiredRequired Question(s)
To prepare for the arrival of Puerto Rican families fleeing the devastation of Hurricane Maria, the Lehigh Conference of Churches is gathering a list of mission leaders and support people from area congregations so we will have a core group available to serve the needs of this specific community. Please complete the following information to join this effort to provide important support for families entering our region. We will use this information to contact you about opportunities to help and keep you informed about this initiative.
 
Required 1.

First Name 

 

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Required 2.

Last Name

 

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Required 3.

Church or Organization

 

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Required 4.

Email Address

 

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5.
Please enter the additional contact information indicated below. 

Job Title:
Work Phone:
Home Phone:
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

6.

If desired, please list any other members of your congregation that would like to be added to this group, along with contact information.

 

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7.

If desired, please list any physicians, dentists, lawyers, counselors, or other professional contacts within your organization that might be willing to help with this initiative. 

 

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8.

Please list any other information about you or your church or organization that might be helpful to this initiative. 

 

1000 characters left.