Event: "We Are Power" Conference - March 2014

Please copy and paste this template, then bring it with you to the conference in March.

If you are under 18, please make sure to get your parent/guardian to sign where it says "signature."

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First Name:
Last Name:
Mailing Address:
Cell Phone Number:
Email Address:
Age:
Parent or Guardian Name:
Parents/Guardian's Signature (do not forget this!)"
Ethnicity:
Career Area of Interest:
Grade:
School Name:
Do you attend church or another place of worship?
If Yes to the last question, what is the name of your place of worship?
If Yes to the last question also, what is your Pastor or worship leader's name?

 

 

 

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