Baby Bottle Drive Registration

Church Information

Kick-Off Dates: Saturday April 26th and Sunday, April 27th, 2026
Church Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pastor*

First NameLast Name
Main Contact Person (Liaison)*

First NameLast Name
Main Contact Email Address*
example@example.com
Main Contact Phone Number*

Area CodePhone Number
Current Church Office Hours*
Church Service Times*
Typical Service Attendance (Combined Weekly Total)*
Will a table be available for Stanton materials? (prefer 6' table for our tablecloths/materials)*

YesNo, please provide
Which video length do you prefer? (Best results are achieved when sharing our video with your congregation.)*

5 minute option3 minute option90 second option
Would you like a Stanton representative to speak at your service(s)? If yes, please indicate for how long in the comments section below.*

YesNoPlease confirm with us approx. 30 days prior
Comments or Questions
Baby Bottles will be receieved by Stanton on Sunday, May 18th at the conclusion of services.

Please contact Atalie with questions or changes to information on this form.

(208) 608-3431

atalie@stantonhealthcare.org

Launch Day Preparation