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Parental Alienation Group - Interest Form
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First Name
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Last Name
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Email
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Phone
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How did you hear about the group?
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If you were referred by an individual, what is their name?
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Are there any methods of contact that need to be avoided for confidentiality purposes?
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Other:
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Kindly list your ex-spouse(s) full name with maiden included.
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In order to provide you the best support, ex-spouses may not join the same group. Registration will be based on first come, first serve. Thank you for understanding.
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