How can we assist you?
Help prepare resource bags for Hartford Residents. Each bag contains information about community resources, local churches, and tracts.
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Event Registration
“*” indicates required fields
Name*
First
Last
Email*
Phone*Church / Organization* Stay in Touch
I’d like to receive email updates about Urban Alliance news and events
Additional Contact InfoName of Your Program/Ministry* Your Mailing Address*
Street Address
Address Line 2
City
AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
State
ZIP Code
Group InformationTotal Number of People in Your GroupIncluding youGroup Member NamesOne per line, pleaseMealsWill you be joining us for the meal(s)?*
Yes
No
List any dietary restrictions HiddenAdmin FieldsNameThis field is for validation purposes and should be left unchanged.
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