Confidential Connect Card


I want information on JOINING the following confidential healing group for my personal needs:
    Men's     Wives'     Teen's     Pastor's

I want ESTABLISH an AVENUE Chapter at my church and begin the following group(s):
    Men's     Wives'     Teen's     Pastor's

I/Others from my church want to ATTEND the next AVENUE Leadership Training Intensive for:
    Men's     Wives'

I'm interested in FACILITATING the following confidential healing group:
    Men's     Wives'     Teen's     Pastor's

 I'm interested in becoming an AVENUE POINT PERSON at my church (liaison between AVENUE and my Church)

 I'm interested in becoming an AVENUE AREA DIRECTOR (an overseer of AVENUE Point Persons in a region)

I'm interested in scheduling an AVENUE SPEAKING ENGAGEMENT at my church for (often used as a catalyst to form or add members to existing groups):
    Men's     Wives'     Both

I want more information on how my church could HOST a regional event for:
    Men's     Wives'     and/or Training's

 I want to start receiving AVENUE's NEWSLETTER

I would like to partner with AVENUE in equipping churches to minister healing to people impacted by sexual sin in the following manner:
    

Name:  
 
Address:   City:   State:   Zip:  
 
E-mail Address:  
 
Home/Cell Phone:   Work Phone:  

Church Name/Denomination:  
 
Approximate Adult Weekend Attendance:  

How did you first hear about this AVENUE event? (i.e. T.V, radio station, newspaper, church, pastor, friend, etc.)