| Church Name | |
| Church Street Address | |
| City | |
| State/Province | |
| Zip/Postal Code | |
| Notes regarding the church address provided | |
| Chairman FIRST Name | |
| Chairman LAST Name | |
| Chairman Street Address | |
| City | |
| State/Province | |
| Zip/Postal Code | |
| Notes regarding the chairman info provided | |
| We'll be running these programs | |
| Total # boys anticipated to participate | |
| The "Working Agreement" identifies our mutual responsibilities and can be viewed here: csbministries.org/workingagreement | |
| Region | |
Staff