Grant Application

Register As A Witness For Free Electricity

To register as a witness for free electricity for the Kings and Priest Program, please fill out the form below. All required fields that are shown in bold, must have valid values. It is critical that you include a valid e-mail address. At the end of the registration form, you will be asked where you would like to see the money generated by your witnessing go. When you are done, press the submit button. If all the fields are valid, a confirmation screen will be displayed and you will receive a confirmation e-mail. Prior to the event, a Free Electricity Certificate will be assigned to you and a PDF version of the certificate will be e-mailed to you. If you do not have an e-mail address, and cannot use a friend of relative's, a Certificate will be mailed.

Please note that we do validate all USA addresses using the US Postal Service Address Verification Services. If either the mailing or physical address listed does not validate, the computer will not accept the application. In this case, please check with your Post Office for the proper designation for your location.

Fill out the information shown below. Fields in bold are required.

First & Last Name:

Home Phone: (817-333-5555)

Work Phone: (817-333-5555 or 817-333-5555x12345)

Other Phone: (817-333-6666 cell)

Email address:
(name@domainname.com)

PHYSICAL ADDRESS

Street:
(PO Box not permitted)

Apartment Number: (i.e. Apt. #123)

City:

State/Prov:

Zip/Postal Code: (US 12345 or 12345-1234, Canada A1B 2C3)

Country:

MAILING ADDRESS (if different from physical address)

Street:

Apartment Number:

City:

State/Prov:

Zip/Postal Code: (US 12345 or 12345-1234, Canada A1B 2C3)

Country:

Give Grant To:
(Which of the following issues would you prefer to see addressed with the funds generated from your witnessing? You may e-mail us if you have other suggestions.)

First & Last Name:
Home Phone:	(817-333-5555)
Work Phone:	(817-333-5555 or 817-333-5555x12345)
Other Phone:	(817-333-6666 cell)
Email address:	(name@domainname.com)
PHYSICAL ADDRESS
Street:	(PO Box not permitted)
Apartment Number:	(i.e. Apt. #123)
City:
State/Prov:
Zip/Postal Code:	(US 12345 or 12345-1234, Canada A1B 2C3)
Country:
MAILING ADDRESS (if different from physical address)
Street:
Apartment Number:
City:
State/Prov:
Zip/Postal Code:	(US 12345 or 12345-1234, Canada A1B 2C3)
Country:
Give Grant To:	(Which of the following issues would you prefer to see addressed with the funds generated from your witnessing? You may e-mail us if you have other suggestions.)