FAITH-BASED ASSOCIATES FORM

Please, if you are interested, check ALL THAT APPLY:

Being a Host Site for Speak-Up-Sunday Being a host site for Project Good Samaritan Meetings Participate in Community Meetings Securing volunteers for Crime Stoppers events Serving on our Faith-Based Program Focus Group

Organization Name

Address

City

State

Zip

Pastor's Name

Contact Person

E-mail

Telephone #

Fax #

Does Crime Stoppers have permission to use your organization's logo on our website, social media and in publications as a faith based supporter?

Please list ministries, outreach programs, special trainings and/or certifications currently existing in your organization that could assist Project Good Samaritan in our work of serving families victimized by crime and violence

Please include names and contact information for any additional contacts who would like to receive Crime Stoppers updates:

IF YOU WANT TO BECOME A CONTRIBUTING FAITH-BASED ASSOCIATE:

Supporter's Level

OTHER:

Receive Invoice ViA

Payments methods

CHECK -Please make checks payable to: Crime Stoppers of Michigan. Mail to: Crime Stoppers of Michigan 18000 W 9 Mile Road, Ste 500 Southfield, MI 48075 OTHER - Stacey Kowalski will contact you for other forms of payment.

Crime Stoppers of Michigan is a 501(c)(3) organization. All contributions are tax deductible to the extent permitted by law.

CONTACT

Please take a moment to share any feedback, questions or concerns you may have!