Declaration form of a Zacchaeus course
* Required
Country
*
Your answer
City
*
Your answer
Name of the person in charge of the course
*
Your answer
Surname
*
Your answer
Personal email
*
Your answer
Personal address
Your answer
Date for the beginning
MM
/
DD
/
YYYY
Place of the course
Parish
At home
At work
Other
Clear selection
What is the language of the course?
*
Your answer
Specificity of the course
Led by the Emmanuel Community
Specific for young professionals
Clear selection
Is it a new course?
Yes
No
Clear selection
How many participants?
Your answer
How did you hear of the Zacchaeus Course?
*
Through word of mouth
By your parish
In a session in Paray-le-Monial
On internet
Other
Required
Comments
Your answer
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