Outreach Ministry Interest

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Name

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Email

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Phone

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Address

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Are you a member?

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Please select all that apply.

Yes No

Have you completed New Member Class?

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Please select one option.

Yes No Not Sure

Do you current serve in this area?

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Yes No

Date of Birth

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Area of interest?

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Please select all that apply.

Outreach Team Administration Unsure

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Description

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