College Group Form – Fairfax Church

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Name*

First Name Last Name

Cell Phone*

Email Address*

Date of Birth*

Address*

Street Address City State ZIP Code

Current Status*

Currently Studying

Graduated

Employed

Other

How can we help you connect?

Check all that apply.

I want to join a group

I want to serve on a team

I want to receive care/talk to a pastor

I have questions about the Bible or church

I have a prayer request

Comments

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