Skip to main content
Close Search
search
Menu
ABOUT
COMMUNITY IMPACT
SERVICES
COACHING
WORKSHOPS
KEYNOTE
SALES MINDSET
PODCAST
GRANT RESOURCES
INSURANCE SERVICES
TAKE ACTION COMMUNITY
BLOG
CONTACT
facebook
linkedin
youtube
instagram
spotify
search
Fast for a Cause Form
Fast For a Cause Participation Form
Hidden
Next Steps: Sync an Email Add-On
To get the most out of your form, we suggest that you sync this form with an email add-on. To learn more about your email add-on options, visit the following page (https://www.gravityforms.com/the-8-best-email-plugins-for-wordpress-in-2020/). Important: Delete this tip before you publish the form.
About You
Your Name
(Required)
First
Last
How Can We Reach You?
Michael will send fasting suggestions and updates for when he plans to go live on social media so you can get the support you need as you participate in this challenge.
Preferred Method of Contact
Email
Phone
Your Email Address
(Required)
Email Address
Confirm Email Address
Your Phone
(Required)
Where can we find you on social media?
(Required)
How long to you plan to fast for a cause?
(Required)
16 hours
24 hours
48 hours
72 hours
How much are you going to be donating for this cause?
(Required)
$1 per hour
$2 per hour
$5 per hour
$10 per hour
Even More!
This helps Michael track donations.
Your Comments/Questions
(Required)
Close Menu
ABOUT
COMMUNITY IMPACT
SERVICES
COACHING
WORKSHOPS
KEYNOTE
SALES MINDSET
PODCAST
GRANT RESOURCES
INSURANCE SERVICES
TAKE ACTION COMMUNITY
BLOG
CONTACT
facebook
linkedin
youtube
instagram
spotify