Chez Vous:  My Core Information
Application Form A. Please fill in and submit at the end.
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Full Name *
Preferred Name *
Email Address *
Alternate Email Address
Mobile Phone Number *
+1.XXX.XXX.XXXX
Home Phone Number
+1.XXX.XXX.XXXX
Birthdate *
MM
/
DD
/
YYYY
Gender *
Full Address while at school *
Street/Box/Apt, City, State ZIP
Full Address while at home *
Street/Box/Apt, City, State ZIP
Applying for ... *
The Chez Vous experience includes a brief worship time every class day . . . would you happen to play an instrument with which you would be willing to participate? *
If yes, what instrument do you play?
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