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ZWOL Registration: DC@WS Fall '21
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Email
*
Your email
Name (first and last)
*
Your answer
Email Address
*
Your answer
Mobile Phone Number
*
Your answer
Please check all ways you prefer to be contacted.
*
Email
Phone
Text
Required
City and State of Residence
*
Your answer
Gender
*
Male
Female
Age
*
Your answer
How did you learn of DC@WS?
*
Pastor
Counselor
DivorceCare Leader
Previous Wildstream participant
Wildstream's website
Other:
Name of person who referred you to Wildstream
*
Your answer
Have you taken DivorceCare previously?
*
Yes
No
Currently enrolled
If you have taken DivorceCare, please list where and when your class was held.
Your answer
Where are you in the divorce process?
*
Filed
Not final
Separated
Divorce final
Required
If final, how long have you been divorced?
Your answer
Do you have any children? If so, how many and what ages?
*
Your answer
How long were you married?
*
Your answer
Please tell us a little more about you and what you hope to gain from DC@WS.
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Your answer
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