Because They Made a Difference Story Telling Form

*Please note there is no save and continue feature and this form should be completed entirely before hitting submit. If you would like a blank copy to print, click ctrl + p or command +p.

Your First and Last Name *

Email *

Your Church

Person you're naming as a "Difference Maker" *

Role this person played in your life? (Pastor, Youth Minister, Family Ministries Director, etc.)

 Optional: Upload a photo of the person you are honoring (with permission). Acceptable files: jpg and png.   

Please print this form for your records before hitting submit by clicking ctrl + p or command +p.

Once you hit submit, a confirmation window will open with instructions to make an online donation.

If you wish to send in a check, mail to:
Northern Illinois Conference
Attn: Difference Makers
PO Box 5646
Carol Stream, IL 60197-5646

*if you don't receive a confirmation email, please check your spam folder

Difference Makers Story Form

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