Bible Request Form

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This field is for validation purposes and should be left unchanged.

Timeline: Please allow 1–2 weeks for a reply on approval. After approval, allow up to 2 additional weeks for us to order the appropriate Bibles and have them ready for pickup.

1.) Requestor Information

Date(Required)

Organization/Group/Church/Individual Name:(Required)

Requestor Name & Title(Required)

Phone(Required)

Email(Required)

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

2.) Who will receive these Bibles?

Event/Program name (if applicable):(Required)

Estimated number of people who will receive a Bible:(Required)

Describe the population (e.g., church members, youth, inmates, patients, students, homeless outreach, etc.):(Required)

3.) Bible Details

Preferred Translation/Version (e.g., KJV, NIV, ESV, Spanish Reina-Valera):(Required)

Requested Quantities (by type if mixed):(Required)

Date needed by (if any):(Required)

4) Pickup & Ministry Presentation

Will you pick up in Tupelo, MS? (Yes/No):(Required)

Yes

If no, explain:

Are you open to a Just Jesus inc representative sharing about the ministry in front of your group, church, or organization? (Yes/No):(Required)

Yes

If yes, preferred date(s)/service time(s) and location:

5) Additional Notes (optional)

Photo Request

If possible, please send us pictures when distributing the Bibles. Photos may be used for Just Jesus inc ministry updates and encouragement.

Agreement

I understand these Bibles are provided free of charge for ministry use only and are not to be resold. I agree to pick up within the communicated timeframe and will confirm receipt. I understand that submitting a request does not guarantee approval.

Agreement

I/We will email photos after distribution (if possible) for ministry use and updates.

Signature

Date(Required)