Name (first and last):
Date of Birth:	January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Decline to state 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925
Group Name (only if applicable):
Street:
City, State & Zip Code:
Day Phone:
Evening Phone:
Cell Phone:
Email Address:
Emergency Contact & Contact's Phone Number:
T-Shirt Size:	Small Medium Large X-Large XX-Large
I would like to attend on these dates! (Attend on as many days as you would like)	Saturday, April 18 Sunday, April 19 Monday, April 20 Tuesday, April 21
This is my fundraising goal! (The minimum goal to attend is $200 per day)
I would like to be assigned to the Women Build! (The Women Build house will be framed exclusively by women during the event)	Yes No
I'm a Lutheran! (Lutheran participation helps us fulfill our commitment to our Thrivent Builds sponsorship)	Yes No
How did you hear about this event? And other comments/questions:
"I understand that this is a fundraising event and that I must raise the minimum requirement to participate"	Yes No