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* 1. What is you contact information?

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* 2. What is your race/ ethnicity? (Please select all that apply)

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* 3. When is your birthday?

Date

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* 4. What is your gender identity?

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* 5. How did you hear about Vision Church Los Angeles?

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* 6. What was your last ministry of affiliation, if any?

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* 7. My interests include (please select all that apply):

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* 8. Would you recommend a friend or family member to Vision LA?

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* 9. What is your preferred mode of contact?

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* 10. What is something you look forward to experiencing with Vision LA or anything else you would like to share?

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