KidCare America
 Training Registration

A new approach to training is being implemented for 2008. Please contact Nancy at 417-866-8864 or email her at nferguson@afterschoolmentoring.org


Name:
Home Address:
City:
State:
Zip:
Email:
Home Phone:
Cell Phone:
Work Phone:
Church Name:
Church Address:
City:
State:
Zip:
Church Phone:
Pastors Name:
What center are you interested in opening? (choose one)
What is your role at the Center?