Please enroll the following disciple

Please Select Men's Encounter April 20-22 Women's Encounter April 27-29

Last Name   First Name

Address 

City  State Zip

Email Address  

Home phone   Cell Phone

Cell Pastor Name and E-Mail Address

I have collected the $30 deposit

(You may make Paypal payments HERE)

I have informed my disciple to attend the pre and post encounter classes

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