FLMI Webinar Form

Perfect Men Discipleship Program

Please fill in the form below.
Full Name *

First Name Last Name
Age *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Phone Number *

Area Code Phone Number
First time to participate in group? *

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Days of Availability (NOTE: Meeting date is not determined by attendee's availability):

Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Please Note: We reserve the right to deny participation in the group for ANY reason. If program is full, don't worry! These sessions are ongoing.
Should be Empty:

Perfect Men Discipleship Program