Mail completed form and Check to:

Ba’Ruch Ministries
  P.O.Box 1333
  Crystal Lake, IL 60039-1333

Name:___________________________________________________________________

Address:_________________________________________________________________

City:_____________________________________________________________________

State:___________________________________ Zip:_____________________________

Phone:______________________________ Email:_______________________________

Your Church/Ministry:________________________________________________________

_

Date:__________________________

 Free Will Offering to be Received

          No Special Accommodations for Children