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Phone No Required *

Email

Are You Born Again Please select Yes No unknown Required *

Are You Field with the Spirit Please select Yes No unknown Required *

Have you completed Foundation School Please select Yes No Like to join Other Required *

Have you been baptized Please select Yes No Unknown Required *

Are you a member Please select CE Northshore CE Indiana CE Minnesota CE Mississippi Other Required *

Would you like to be a Member Please select Yes No Required *

Marital Status Please select Married Single Other Divorce

Prayer Request

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