I Am The 73rd / Yo soy el 73

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Sign-up for an upcoming Consecration / Regístrese para nuestra próxima Consagracion

Full Name / Nombre completo *

Cell Phone Number / Numero de Cellular *

Email Address / Correro Electronico *

Address / Domicillio

City / Ciudad

Other:

State / Estado

Other:

Country / Pais *

USA

Other:

Birthday / Fecha de Nacimiento *

YYYY

Which Consecration dates are you interested in? / En qué fechas está interesado?

January 27th - March 1st

March 24th – April 26th

May 19th – June 21st

July 21st – August 23rd

October 20th – November 22nd

Sex / Sexo *

Male / Hombre

Female / Mujer

Preferred language / Idioma Preferido *

English

Español

How did you hear about us? / ¿Cómo se enteró de nosotros? *

At an ESNE Event / Evento de ESNE

By a Friend or Relative / Por un amigo o familiar

Social Media / Redes Sociales

Other:

Person who referred you / Patrino o Madrina

Name of person who referred you to the 73rd / La persona que le remitió al 73.

Questions? / Preguntas?

Privacy notice of your personal data:

I Am the 73rd makes itself responsible for the use and protection of your personal data shared in this form. Your personal data will only and exclusively be used to carry out the objectives of I Am the 73rd; in completing this form you agree that we may contact you via phone calls, e-mail, SMS, or through the platforms of WhatsApp and Telegram; this would also include permitting us to enroll you in group chats on the platforms previously listed. For more information please visit our website iam73.net / write us at info@iam73.net / call us via telephone at +1 818 912 5842, or message us to the same number via WhatsApp or Telegram.

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