Tidal Impact Survey Participation

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* 1. I am interested in participating in a focus group to help give input into the future of Tidal Impact?

Extremely interested

Very interested

Somewhat interested

Not so interested

Not at all interested

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* 2. My role in youth ministry is...

'Next Generation' Pastor

Volunteer Leader

Solo Pastor

Tidal Impact Area Team Member

Other (please specify)

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* 3. Email

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* 4. Full Name (first, last)

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* 5. Name of Church congregation you attend