IMPACT TEAM REquest Name Church Date Please note that all our impact team request are on the 4th Saturday of every month Saturday 22nd Jan Saturday 26th Feb Saturday 26th March Saturday 23rd April Saturday 28th May Saturday 25th June Saturday 23rd July Saturday 27th August Saturday 24th September Saturday 22nd October Saturday 26th November Arrival Time Hour Minute Second AM PM Event Time Hour Minute Second AM PM Meeting Address Event Address Contact Email * Contact Phone Number Event Type (Select all that apply) Drama Only Concert Only Concert & Drama Music on the streets Outreach Only (not event in the evening) Thank you for taking the time to complete the form. A member of our team will be in touch shortly.