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* 1. I am a:

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* 2. In 2015-2016, my child/children will be a (check all that apply)

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* 3. What are the ways you think your child would be interested in serving, or is already serving, the church (check all that apply):

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

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

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* 6. What are one or two things you would like your children to learn about in Youth Fellowship, whether your children participate, or not?

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* 7. What are the ways you might be willing to assist with the Youth Fellowship Program? (Check all that apply)

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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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