BOTR Church Application Before You Begin• Read the BOTR General Information documentName First Last Cell Phone #Email Church NameChurch Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Church Phone #Church Email* Church Website* Church Sunday Attendance*Available Camp Dates* June 9-12 June 16-19 June 23-26 June 30-July 3 July 7-10 July 14-17 July 21-24 August 4-7 Select all that applyWhich week would be your first choice?*June 9-12June 16-19June 23-26June 30-July 3July 7-10July 14-17July 21-24August 4-7Site Facilities Gymnasium Sports Fields Hill (used for Slip 'N' Slide) Number of Meeting Spaces/Classrooms*Why do you want "Beulah on the Road" to be held at your church?How many children do you have attending weekly childrens' ministries?Expected number of campers (must be at least 100 campers)*Please feel free to add any additional information or questions here.I have read the "Beulah on the Road" general info sheet.* Yes Electronic Signature