Group Location AD Signup

This form is the information we need to place an ad on StandUpGirl.com under Local Pregnancy Help listings.

"*" indicates required fields

Name of Person Submitting Request*

The person who is responsible for checking your ad once it is LIVE.

First Last

Contact Person Email*

Contact Person Phone*

YoungLives Group Name*

Suggestion, YoungLives Group [city name]. Keep it short as possible.

Area Coordinator who gets notifications from women wanting to join your local group.

Area Coordinator Name*

First Last

Area Coordinator Email*

Group Address*

Needed for ad Geo-location. No PO boxes!

Street Address City State / Province / Region ZIP / Postal Code Country

Do you want your address on the ad?*

Yes

No, use the "Mentoring and Peer Community for pregnant and parenting teens"

Questions or Message?

How may we help?

Phone

This field is for validation purposes and should be left unchanged.

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