The Well Interest Form

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Thank you so much for your interest in participating in the well! This interest form just helps us to plan for night one and communicate with those interest leading into the well. THIS IS NOT AN OFFICIAL SIGN UP OR REGISTRATION. We will do an official sign up at the end of the first session, so come, check it out, and if you think you'd like to continue with us, you can officially sign up then!

What is your name? *

What is your email? *

What is your phone number?

What year in school are you? *

Freshman

Sophomore

Junior

Senior

Grad Student

Other:

Are you currently attending a Connect Group

Yes, Wednesday Group

Yes, Thursday Group

Other:

Clear selection

Any questions or comments for us?

Submit

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