Application Form REVIVE / REFRESH (2nd Year)

Spiritual Information
How would you describe your current relationship with the Lord.*
Do you attend a church or small group regularly?*
- Yes
- No
How long have you attended?
Home Church or Small Group
Pastor or Group Leader's Name
What interests you most about REVIVE/REFRESH?*
Agreement
I understand that any falsification of information on this application is grounds for dismissal at any time. I hereby certify that the information I have supplied herein is true.
Do you agree?*
- By checking this box you agree to the above statement (Agreement)
Phone
This field is for validation purposes and should be left unchanged.

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Section 1: Personal Information