Sharing an act of love...

How I demonstrated Jesus' love...

Your Name

Recipient's Name

Act of Love Offered

Date Act of Love Offered

In what city and state do you live?

We are keeping a record of all acts of love offered.

Do we have your permission to share this act of love online?

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no

If yes, may we use your first initial and last name?

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no

Do you want to join our mailing list?

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no

Email

Address

Apartment, suite, etc.

City

State

Zip/Postal Code