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* 1. Contact Information

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* 2. Age

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* 3. I am involved in my local Congregational Men’s groups

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* 4. I have attended______Regional Men’s Events

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* 5. Based on my attendance at the Regional Men’s events, I have:

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* 6. What I have enjoyed most about the Men’s retreats I have attended has been:

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* 7. My lack of attendance at Regional Men’s Events was due to:

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* 8. I am interested in the following learning opportunities provided by the Region:

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* 9. If I had to choose 3 topics for Men’s Retreat, they would be:

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* 10. I would like to help in planning Men’s Retreat this year

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* 11. If I had to choose one thing to add to Men’s Retreat, it would be:

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* 12. I think the Men should have a One day Spring event in addition to the fall retreat. 

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* 13. I would be interested in participating in a one day Men’s community work project

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* 14. I would be interested in participating in a Saturday regional church charity golf scramble

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* 15. My church would be interested in hosting a Saturday tailgate at men’s retreat. (WVU plays in Morgantown, Marshall plays away)

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* 16. Please subscribe me to the weekly regional newsletter

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