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Thank you for taking the time to fill out this form!
These items will help us to stay connected with you and give you
helpful resources as you grow in your relationship with Jesus.
First Name
*
Last Name
*
Email
*
Phone
*
Age
*
Gender
*
Male
Female
Primary Language
*
English
Spanish
Other
Other
Where do you live?
*
What happened?
*
I recently gave my life to Christ for the first time.
I recently rededicated my life to Christ.
I have been walking with the Lord for some time, but want to grow in my relationship with Jesus.
Are there any topics you'd like to address in this class?