Choices PRC Now - Sanctity Request Form

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Sanctity of Human Life Sunday

Bulletin Inserts, Video, and Speaker Request Form

All requests must be submitted no later than January 9^th

Last Name

Phone

Please enter digits only. Example: 8920803 or 4238920803

Church

Church Phone

(Most churches will observe SOHLS on 1/15/12 or 1/22/12)

Date of SOHLS service (MM/DD/YYYY format)

Number of bulletin inserts needed

Check if your church like a five minute video of our client testimonies.

Check here if your church would like a speaker from Choices to share about the Sanctity of Human Life and the role of pregnancy care centers and local churches in the preservation of life. Speakers are available to speak throughout the year during Sunday morning services, Wednesday night services, small group meetings, or Sunday school classes.

Details: Please note the date, time, time allotted, and setting for which you are requesting a speaker

Date you will be pickup up your inserts (MM/DD/YYYY format)

Name of person picking up inserts

First Name

THANK YOU!

Your Sanctity of Human Life Sunday

submission has been received.