Virtual: Adult Life SUMMIT

First Name With Title*

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Ex: Archbishop Foley

Last Name*

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Beach

Street Address*

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301 Leetsdale Industrial Drive

City*

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Leetsdale

State*

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PA

Zipcode*

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15056

Phone Number with area code*

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Email address*

We need a valid email.

Church or Organization Name

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Diocese

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Bishop Name*

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I would like to learn more about...*

Starting an AFL Chapter

Appointing a Life Leader in my church

Becoming a Life-Affirming Church

None of the above

Select as many as apply.

I would like to be added to AFL's....*

Snail mail (USPS) list

Email list (we won't spam you)!

Prayer Team

Please don't sign me up for anything.

Did someone refer you to our event? If so, please type their first and last name below.

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Georgette Forney

I have added info@AnglicansForLife.org to my contacts.*