Mortgage Relief Outreach Event Participation Form

 

“Preserving the American Dream”

Mortgage Relief Event

 

Saturday, June 21, 2014

 Apostolic Church of God

6320 S. Dorchester, Chicago, IL

10:00 am – 2:00 pm

 

PARTICIPATION CONFIRMATION FORM

 

 

Name of Organization: ____                                                                       ________________________

 

Street Address: __                                                         _______________________________________

 

Telephone Number: _                              __________________________________________________

 

E-Mail: _                                        ________________________________________________________

 

Contact Person: __                __________________________________________________________

 

 

 

Please check services you will provide: (check all that apply)

 

Housing Counseling                        Legal Services          Social Services                    Volunteers

 

Number of tables needed:             One                 Two

 

Representative(s): _1)                                                             2)    ________________________________            

 

3)                                                                                  4)                                                                               _

                       

 

 

PLEASE NOTE:

 

v  Each booth set-up includes one (1) 6’ table and two (2) chairs.

 

v  Set up starts at 9:00 am.  Doors open at 10:00 am.  Refreshments and Lunch will be provided.

 

v  Please email form to Steeve Kidd – skidd@genesishdc.org or fax to (773) 994-6673. Contact Steeve Kidd at (773) 994-6670 x214 with questions.

 

Confirmation due by June 2, 2014