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Title/Position:

First Name: *

Last Name: *

Email: *

Cell Phone:

Phone (Main):

Address (Home): *

City: *

Province: *

Postal Code: *

Spirituality or Denomination:

Year of Birth:

Join Email Lists: *

- - KAIROS TIMES e-newsletter [monthly]

- - Events & Urgent Actions

- Edmonton Press

I'm interested in: *

Participation: *

Attended KAIROS event(s)

Organized/hosted KAIROS event(s)

New to KAIROS

Interested in connecting with a KAIROS local group

Active in this KAIROS Group:

or/and Other Group, Church or Community:

KAIROS Blanket Exercise:

Experienced the Blanket Exercise

NOT experienced the Blanket Exercise

Indigenous Identity:

Diaspora Identity:

Anything else to tell us about yourself or your connection with KAIROS?

Ecological Justice	Gender Justice and Global Partners
Migrant Justice	Spirited Reflections / Worship Resources
Indigenous Rights