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*Name:
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Street Address:
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City:
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State:
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Zip:
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Phone Number:
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Email Address:
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Have you attended a Service at Knobbs Springs Baptist Church:
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Birthday:
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Spouse's Name:
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Spouse's Birthday:
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Wedding Anniversary:
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Childrens names & Birthdays:
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| *Authentication: |
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| *10 + 6 = |
Enter the correct answer to the math question. |
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