GraceWorks Alaska
4149 Checkmate Dr.
Anchorage, AK 99508
907-440-4974
gograceworks@aol.com
Spring Xtreme 2019
March 9-14; March 16-21; March 23-28; March 30- April 4 (circle one)
Name ______________________________________ Birthdate ___________________________________
Address ____________________________________________________________________________________
City _______________________________ State __________________ Zip ________________
Phone (cell)__________________________ Email _______________________________________________
Employer (if student, name school) _____________________________________________________________
Church where you attend ______________________________________________________________________
Past Ministry Experience ______________________________________________________________________
Health Concerns or Disablities? (if so, please detail on the back)
Emergency Contact Name and phone ____________________________________________________________
Please attach (1) a brief recommendation email from your pastor, church pastoral staff member or someone else in who knows you well (2) $50 deposit to hold your place – applied to your total. (3) We also require applicants to send us a background check before you come. Send payment to: GraceWorks, 4149 Checkmate Dr, Anchorage, AK 99508.
Copyright GraceWorks Alaska © 2019
GraceWorks Alaska is a 501(c)(3)
tax-exempt organization.
All donations are tax deductible
as allowed by law.