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Worship in Pink Weekend 2017

 

Worship in Pink

October 6-8, 2017

Worship in Pink

To participate in the Worship in Pink (WIP) program, please submit this registration form. It is highly recommended that your WIP program is registered by September 8, 2017. For questions, please call Mission Coordinator, Elizabeth Hand, at (540) 400-8222 x3.

"The WIP Coordinator will be the MAIN point of contact for questions and updates about each organization’s WIP registration, including educational packet pick-up and speaker requests. Please ensure that the WIP Coordinator is able to respond to emails and phone calls about WIP registration in a timely manner".

 

 


 

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Question - Required - Please note the preferred method of communication for each WIP coordinator:

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Question - Required - Please let us know how you would like to receive your educational packets. Material can be mailed to faith-based organizations; however, we encourage organizations located in the Greater Roanoke Valley to arrange a time to pick up education packets.


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**The educational packets come in packs of 50 and are limited. Packets will be dispersed on a first-come-first-served basis. Please return any remaining education packet material after WIP.**

* Ethnic Breakdown of Recipients:
(Select one of the available choices or enter a different value.)



* Language Breakdown of Recipients:
(Select one of the available choices or enter a different value.)



 

** Information can be provided for different ethnic groups and in different languages-please contact the office to learn more**

 

 


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Question - Required - Planned Educational Activity (Please check at least one):

 

(Maximum response 255 chars, approx. 5 rows of text)

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Question - Required - Other Activities Planned (Check all that apply):

 

(Maximum response 255 chars, approx. 5 rows of text)

 


 

*Please note: The Virginia Blue Ridge Affiliate of Susan G. Komen recommends each faith-based organization find a congregation member to serve as a WIP speaker.   The Virginia Blue Ridge Affiliate has trained breast health awareness speakers; however, speakers are limited and will be scheduled based on availability.

If you would like to speak in further detail about WIP education activities, please contact Mission Coordinator, Elizabeth Hand at ehand@komenvablueridge.org or (540) 400-8222 x3.

 

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