Registration for "Becoming an Anti-Racist Church and Community"

First Congregational United Church of Christ

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* 1. Your Name:

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* 2. Check One of the Three Boxes Below

First Congregational UCC Member

Other Faith Based Organization Member

Community Member

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* 3. Today’s Date

Date / Time

Date

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* 4. Will You Be Engaging in Primarily Self Study and Reflection (No Group Discussions)?

Yes

No