June 26 - June 29 ~ Dallas, Texas

What is your first and last name?

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* 1. What is your first and last name?

Your Contact Information

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* 2. Your Contact Information

Name of Church & Pastor

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* 3. Name of Church & Pastor

Name of High School, College or University

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* 4. Name of High School, College or University

Please Check All That Apply

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* 5. Please Check All That Apply

Have you done the following?

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* 6. Have you done the following?

List your current leadership activities

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* 7. List your current leadership activities

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