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Registration
Thank you for choosing to register for Chosen's Life Refocused Life Groups!
To register, complete the form below!
If you have any questions or concerns, you may email Pastor Jaqueline Lewis at
msmonyj@hotmail.com
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Name (First, Last)
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
I Will Need The Following Accommodations In Order To Participate
*
Assistive listening device
Captioning
ASL interpreter
Large print ( vision impaired )
None of the Above
Required
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