subject_line
Leaving a Legacy Seminar Request Form
ORGANIZATION INFORMATION
TODAY'S DATE
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Church Name
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Street Address
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Address Line 2
City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Pastor's Name
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Contact Name
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Phone Number
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Cell Phone#
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Fax
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Email Address
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BACKGROUND INFORMATION
Demographics:
Average age of members:
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Number of Married couples:
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Number of Singles:
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Year church established:
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Traditional or Contemporary Service Format:
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Reason for Seminar: (What do You want this seminar to do for your church?)
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