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* 1. Please provide the following information:

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* 2. Number of adults:

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* 3. Number of youth:

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* 4. Choose rank these date options. All congregations will be given either their top or second choice and contact persons will be notified as soon as possible if their top choice cannot be given. All options are $225 a person. Financial assistance is available by contacting Molly at mbeck@sepa.org.

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