CE LAGOS ZONE 1 OCTOBER 1ST CENTER REGISTRATION

Center Cordinator/Representative's title*

Center Cordinator/Representative's Name*

Center Cordinator/Representative's Phone*

Center Cordinator/Representative's Team*

Center Cordinator/Representative's Group*

Center Cordinator/Representative's Church*

Center Cordinator/Representative's Cell

Center Type

Center Name*

Address of center*

Center's Nearest Bus stop*

How many people will be Participating at the center? (minimum of 100)*

How many copies of ROR will be distributed?*

Please type the characters*

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