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* 1. I am a:

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* 2. In 2015-2016, I will be a

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* 3. I would be interested in serving, or am already serving, the church by (check all that apply):

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* 4. Which evenings during the school year, after 6:00 p.m., that you have commitments during the school year that would make it difficult for you to attend youth ministry gatherings? (Check all that apply)

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* 5. I would rate my involvement with Youth Group/Youth Fellowship up until now as:

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* 6. What are one or two things you would like to learn about in Youth Fellowship?

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* 7. Please name one thing that might make you willing to attend at least one meeting of Youth Fellowship.

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* 8. What are the best ways to communicate with you (check all that apply)?

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* 9. Anything else you’d like to tell us?

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* 10. If you wish, you can provide your name and contact information.

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* 11. If you would like someone from Christian Education Ministry to follow up with you, please provide your name and contact information. The information you have provided above will be kept separate from any contact information you provide to us.

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