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Discipleship Deliverance Class Enrollment
October 2020 Classes
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First Name
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Your answer
Last Name
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Your answer
Your Preferred Email Address
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Your answer
Your Address
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Your answer
Your Primary Contact Phone Number
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Your answer
This number is a:
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Cell Phone
Home Land Line
Work Number
Will a spouse attend with you?
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Yes
No
If "yes," what is your spouse's FIRST name? (Enter n/a if a spouse will not be attending.)
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Your answer
If "yes," what is your spouse's LAST name? (Enter n/a if a spouse will not be attending.)
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Your answer
If "yes," what is your spouse's EMAIL ADDRESS? (Enter n/a if a spouse will not be attending.)
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Your answer
Preferred Class Day: Class Times have not been set for the October 2020 Classes Yet. Please select your preferred day and time.
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Monday
Tuesday
Wednesday
Thursday
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Preferred Time of Day
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Mornings (Between 8am - 11am Central)
Afternoons (Between 1pm - 4pm Central)
Evenings (Between 5pm - 8pm Central)
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How did you hear about Whole Catholic Coaching?
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Your answer
What is the Name, City, and State of your home parish? (enter n/a if not applicable)
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Your answer
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