Saint Mary Roman Catholic Church

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Facilitator Registration Form

- Faith Formation

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- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- In the text box below please indicate any areas of interest you may want to facilitate. Such as Bible Studies, Church History, End of Life Workshops, etc..
- Areas of Interest in Facilitating REQUIRED
  Please list any areas you are interested in Facilitating - Such as Bible Studies, Church History, End of Life Workshops, etc..
  Please fill out this field.
- Earliest Date Available for Training REQUIRED Please fill out this field. Please enter a date.
- Topics or Areas you do not wish to facilitate
  Please list any areas, topics or subjects you do not wish to, or are not comfortable facilitating
- Additional Information
  Please provide any additional information you wish, including previous facilitation experience etc..
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