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Business Resource Information Application

Name *
Name
Home address (if you're interested in the print magazine being sent to your home)
Home address (if you're interested in the print magazine being sent to your home)
http://
Are you willing to be contacted by fellow community members? *
Are you willing to be interviewed by Connections at the Cross for future publications or online media? *
*Please CLICK and read the disclaimer/waiver form below BEFORE you click on the submit button * Your digital signature confirms you agree to all terms and conditions there within. *
*Please CLICK and read the disclaimer/waiver form below BEFORE you click on the submit button * Your digital signature confirms you agree to all terms and conditions there within.
I give permission to use my photo in any/all publications
Please email your photo to amy@amyctilley.com

We would love for you to share this amazing community with others so we can grow together and spread the love... HIS love!