ALPHA Registration Form

Please fill out this form and submit to register for the ALPHA course. The ALPHA course starts in September 13, 2017 at 6:30pm in the Philomena Center. If you are interested in finding out what ALPHA is all about, try the Taste of ALPHA on September 6, 2017 at 6:30pm.

If you are human, leave this field blank.

Name *

First and Last Name

Street Address *

City *

Zip Code *

Phone Number *

Email Address

Over 18? *

Yes

If No, please enter age

Will you be attending the Taste of Alpha on September 6, 2017 at 6:30pm? *

Yes

What parish are you from? *

How did you hear about ALPHA?

Do you have any dietary requirements?

We look forward to seeing you!

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