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Nebraska North YWRs
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1.
First Name
(Required.)
*
2.
Last Name
(Required.)
3.
Address (Address, City, Zip Code)
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4.
Phone Number
(Required.)
*
5.
Email
(Required.)
*
6.
Preferred Contact Method
(Required.)
Phone
Text
Email
Mail
*
7.
Were you a YWR at the National or District Level (or both)?
(Required.)
National
District
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8.
Which Convention did you attend (Year and Location)?
(Required.)
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9.
Which District did you Represent?
(Required.)
Atlantic
California-Nevada-Hawaii
Carolinas
Central Illinois
Chesapeake
Eastern
English
Florida-Georgia
Gulf States
Indiana
Iowa East
Iowa West
Kansas
Louisiana-Mississippi
Michigan
Mid-South
Minnesota North
Minnesota South
Missouri
Montana
Nebraska North
Nebraska South
New England
New Jersey
North Dakota
North Wisconsin
Northern Illinois
Ohio
Oklahoma
Oregon
Pacific Southwest
Rocky Mountain
SELC
South Dakota
South Wisconsin
Southern Illinois
Texas
Utah-Idaho
Washington-Alaska
Wyoming
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10.
Would you be interested in attending a District YWR Retreat where you can spend a day in fellowship with other YWRs? Our day would be filled with Bible Studies, Ingathering Events, and simply just fellowship with other YWRs.
(Required.)
Yes
No
Current Progress,
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