Resource Order Form

Thank you for your initiative with Life Forward’s Change for Life baby bottle campaign.

Please complete the following form so we can best prepare you to launch and succeed with your campaign.

First Name

Last Name

Email Address

Phone

(###)

###

####

Name of Church, Workplace or School

Best point of contact (if not yourself)

First Name

Last Name

Launch Date

Date

If other, enter launch date

YYYY

Number of Bottles

1 per family recommended

Number of Fliers/Bulletin Inserts

Number of Posters

Post throughout your church to encourage participation

Would you like a Pack-N-Play for collecting diapers and wipes during your church's baby bottle campaign?

Please note this is optional

Would you like someone from Life Forward to speak with your group when you launch Change for Life?

Would you like us to email an announcement slide for your church?

Questions, comments, additional information you would like to share:

Share Myranda’s story with your church, workplace or school.

Contact:
Sarah Wilcox, Events Coordinator
swilcox@lifeforwardcincy.org
Office: 513.487.7777 ext. 2009