Referral Form
We specialize in facilitating high-impact projects that bring refreshment to the personal needs of ministry leaders. Do you know someone who could use this kind of encouragement? Please take 2 minutes to fill out a short referral form. If approved, we will work hard to bless this minister in a significant way. REVfresh is not able to provide support for a person who needs restoration back into ministry, addiction or trauma recovery, on-going counseling, or emergency medical attention.
I am a part of a Partner Organization with REVfresh
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Minnesota District
South Dakota District
AG Evangelist
Wisconsin N. Michigan District
Not Sure
Other
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Your Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Referred Person's Section
Please fill out the best you can even if you don't know them well.
Referred Person's Name
*
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number. If you have it.
Format: (000) 000-0000.
Place of ministry
Why are you referring this person?
*
What kind of Project are you thinking?
Larger Blessing (up to $5,000)
Smaller Benevolence/ Blessing (up to $500)
Would you or your ministry like to donate to this project?
YES
NO
Maybe. Please keep me in the loop.
Submit
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