2023-24 SEDGM Affiliation Form
Coordinator Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Section
*
Please Select
Bronx
Brooklyn
Columbia
Connecticut
Kentucky
Long Island
Manhattan
New England - North
New England - South
New Jersey - North
New Jersey - South
Ohio
Pennsylvania
Queens
Tennessee
Upstate
Virginia
Westchester
Church Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pastor's Name
*
First Name
Last Name
Church
*
Please Note: if you buy a certificate this is the name of the church that will appear
Back
Next
Cost
Coordinator/Leaders $7/per person
Girls $5/per person
Certificate Fee $5 (automatically added)
How many Sunlight Kids
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Sunlight Kids Names
How many Rainbows
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Rainbows Names
How many Daises
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Daises Names
How many Prim's
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Please Select
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Prim's Names
Stars
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Star's Names
Friends
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Friend's Names
Girl's Only
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Girl's Only Names
Leader's
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Leader's Names
Coordinator
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Coordinator's Names
Back
Next
Payment
Total Due
Payment
*
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( X )
USD
SED Girls Ministries Affiliation 2021-22
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
E-Signature
*
Submit
Should be Empty: