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* 1. Title & Name:

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* 2. Affiliation (Community and/or Jurisdiction):

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* 3. What is your ministry in the Church?

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* 4. Contact Information

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* 5. Which week do you plan to attend?

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* 6. What amount might you be willing to pay for this experience?

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* 7. Can we count on you to assist with any of the following? (Choose all that apply)

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