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Please correct the following:
First Name
Last Name
Address
TX
Email
Mobile Phone
Spouse's Name {if signing up as a couple)
Spouse's Email Address
Spouse's Mobile Phone Number
Small Group Type
Co-Ed
Men
Women
Meeting Day Preference (Select all that apply)
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Meeting Time Preference (check all that apply)
AM
PM
Small Group Preferences (check all that apply)
Adults Only
Kid Friendly
Child Care Available
Are you interested in hosting/facilitating a group?
Yes
No
Comments or Questions about placement
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