Hunger A Faith and Justice Response Registration Form Coordinator/Facilitator Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Church/Organization (if applicable) Email* Phone*How would you like to register for Hunger: A Faith and Justice Response?* Participants register and pay individually based on a sliding fee scale of $35, $55, or $75/person with additional scholarships available. (You will need a minimum of 9 people in your group). Participants register and pay individually, but a faith community, organization, or individual subsidizes their registration costs. A faith community or other organization pays $275, which covers everyone in the group (up to 12 participants). PhoneThis field is for validation purposes and should be left unchanged. Δ