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ZWOL Registration: DC@WS Fall '24
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Mobile Phone Number
*
Your answer
City and State of Residence
*
Your answer
Gender
*
Male
Female
Birthdate
*
MM
/
DD
/
YYYY
How did you learn of DC@WS?
*
Pastor
Counselor
DivorceCare Leader
Previous Wildstream participant
Wildstream's website
Other:
Name of person who referred you to Wildstream
Your answer
Have you taken DivorceCare previously?
*
Yes
No
Currently enrolled locally
If you have taken or are enrolled elsewhere in a DivorceCare group, please list the name of the church/organization, when your class was/is held, and your group leader's name.
Your answer
Where are you in the divorce process?
*
Filed
Not final
Separated
Final
Required
If final, how long have you been divorced?
Your answer
Do you have any children? If so, how many and what ages?
*
Your answer
How long were you married?
*
Your answer
Have you attended a Wildstream Retreat?
*
Yes
No
I am or plan to register for a fall '24 retreat
Please tell us a little more about you and what you hope to gain from DC@WS.
*
Your answer
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