Compass Women - Shelburne Site Registration Form
This is the registration form for Compass Women Shelburne. If you have any questions please contact women@thisiscompass.com
Your Name
*
Email
*
This address will receive a confirmation email
Address
*
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Phone
*
Are you new to Compass Women?
*
Please select one option.
Yes
No
Do you regularly attend Compass Community Church?
*
Please select one option.
Yes, usually in Shelburne
Yes, usually in Orangeville
No
Which study will you be attending?
*
Please select one option.
Tuesday evening
Thursday morning
How did you hear about Compass Women?
*
Would you like to purchase a book for the study?
No, I would not like a book (0)
Yes, but I will pay in person (0)
Yes, and I will pay online ($20.00)
No, I would not like a book (0)
Yes, but I will pay in person (0)
Yes, and I will pay online ($20.00)
Amount
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
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AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
This is the registration form for Compass Women Shelburne. If you have any questions please contact women@thisiscompass.com
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