Request a VBS Summer Team Church/Organization* Address of the Church (where VBS will be held) Street Address City State / Province / Region ZIP / Postal Code Contact Person* First Last Preferred Email* Preferred PhoneAre you interested in pairing up with another church for a double week? Yes No Have you confirmed doing a double week with the church? Yes No If a double week is confirmed with both churches, only one request form is needed. Please coordinate with the other church for which weeks would best work for both prior to submitting this form. NOTE: Both churches will be required to provide a Host Church Info Form once confirmed.Please enter the name of the church you are pairing up with. Request Dates for VBS ProgramPlease select your top 3 week choices from the below boxes. If you are hosting a camp, please pick the best fitting week and list the specific dates of your camp (including requested arrive/departure dates) in the comment box.Please indicate if you are flexible for any week. We are flexible for any week. We are not flexible. The First Choice listed is a confirmed date that cannot be changed. First ChoiceNo preferenceWeek 1 - June 1-8Week 2 - June 8-15Week 3 - June 15-22Week 4 - June 22-29Week 5 - June 29-July 6Week 6 - July 6-13Week 7 - July 13-20Week 8 - July 20-27Week 9 - July 27-August 2Second ChoiceNo preferenceWeek 1 - June 1-8Week 2 - June 8-15Week 3 - June 15-22Week 4 - June 22-29Week 5 - June 29-July 6Week 6 - July 6-13Week 7 - July 13-20Week 8 - July 20-27Week 9 - July 27-August 2Third ChoiceNo preferenceWeek 1 - June 1-8Week 2 - June 8-15Week 3 - June 15-22Week 4 - June 22-29Week 5 - June 29-July 6Week 6 - July 6-13Week 7 - July 13-20Week 8 - July 20-27Week 9 - July 27-August 2Comments about request dates: Do you have a specific student you would like to request for your VBS/camp?