Special Ansu Signup
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Email *
Your full name *
Phone number *
Choose a slot - 20 minutes/session. (If a slot is already full, it does not allow you to choose.) *One slot for each person. The only exception is seriously ill person such as cancer patient may choose two consecutive slots for one or more days.   *
Required
REMINDERS: 

- Please arrive at least 10 minutes before your appointment time for the time to fill out Special Ansu Form. 

- Wear a white shirt, thin pants, and avoid wearing jeans and thick trousers if you are receiving ansu on your legs. 

- Please bring an Ansu donation offering of any amount. 
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