TIPPAH COUNTY, MS | January 28

MISSISSIPPI IMMEDIATE RESPONSE

TIPPAH COUNTY | JANUARY 28 - FEBRUARY 11, 2O26
Full Name:*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone*

Area CodePhone Number
E-mail:*

Confirmation Email
Emergency Contact*

First NameLast Name
Emergency Phone Number*

Area CodePhone Number
Church or Organization
Lodging*
Days you plan to SERVE (check off for each day) Please note: 1/28 and 2/11 are travel days*
Thank you so much for serving with us! Once you submit the form, you will receive a follow-up email with additional information. Please contact us at: immediateresponse@godspitcrew.org if you do not receive the automated response e-mail.

We pray that you have safe travels and we look forward to serving with you!
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