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* First Name
* Last Name
* Birth Date
* Email
* Mobile Phone
* Marital Status
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Single
Married
Divorced
Separated
Widowed
Engaged
Unknown
Spouse Name (if applicable)
* Age Group
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0-4
5-12
13-17
18-25
26-35
36-50
51-65
66 & Above
Name, Gender, Birthday (including year), Age, and Current Grade of each child who will be attending with you
* Campus Attending
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Central Campus
Paragould Campus
* Date You Plan to Visit?
* Day/Hour Attending
Sunday, 8:00am (CC)
Sunday, 9:30am (CC/PC)
Sunday, 11:00am (CC/PC)
Wednesday, 6:15pm (CC)
Other Information
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