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Last Name
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gender
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marital status
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SPOUSE First Name
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SPOUSE Last Name
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SPOUSE gender
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this is a new address
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Street address
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City
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state
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Zip Code
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home phone
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Cell Phone
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Email
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preferred contact method
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Text
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ATtendee Staus
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if 1st or 2nd time Guest, how did you hear about mulder?
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Age Group
11-14
15-18
19-22
23-30
31-40
41-59
60-69
70+
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Names and ages of children living at home
child 1 – name
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age
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child 2 – name
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age
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child 3 – name
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age
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child 4 – name
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age
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I am interested in :
membership class
Yes
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Small groups or sunday school
Yes
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baptism
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my decision today
I am committing my life to Christ
I am renewing my commitment to Christ
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i would like more information
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