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* 1. Name

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* 2. Email

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* 3. Phone Number

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* 4. Would you be interested in helping/leading some of Learning to Lead's signature events listed below?

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* 5. Would you be willing to lead out in a Small Group Activity?

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* 6. Do you have any other ideas that you would like to see implemented in this program? If so, please share your idea below:

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