ARIZONA PRECEPT VIDEO/DVD REQUEST FORM
PLEASE FILL OUT THIS FORM COMPLETELY UNLESS YOU HAVE NO E-MAIL ADDRESS
Course:_____________________________________
Leader Name:__________________________
Place/Date Trained:____________________________
(Training Required only for PUP Leaders)
Address:____________________________________________________________
City:
____________________ Zip:__________ Phone:____________________
E-mail:_____________________
2nd phone contact:_______________________
Is
this address new?____ Is this phone number new?_____
Is this E-mail new?________
Start Date:_______________________ Finish Date:_____________________
Weekday:________________ Time:__________________
Women:_______ Men:_______ Mixed:_______
Place
of study:______________________________________________
City:___________________________
Zip:____________
Major Cross Streets:_______________________________________________
Leader's
Church:________________________________
Lecturer preferred: Kay:_____Wayne:_____Other:_____
Video
Administrator if different from leader:_______________________________
Phone:_____________________ email:
___________________________
*To publish class information: Go
to preceptnetwork.org
Mail Form To: AZ Precept Library, Jacque Coombs, 1503 E. Bart
Circle,
Cottonwood AZ 86326
Or attach to e-mail and send to: chron2015@yahoo.com