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Mr.
Mrs.
Ms.
Mx.
Miss
Dr.
Prof.
First Name
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Last Name
Phone
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Email Address
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State/Province
Country
Afghanistan
Albania
Algeria
American Samoa
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Angola
Anguilla
Antarctica
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Argentina
Armenia
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Ascension Island
Australia
Austria
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Congo, Republic of the
Cook Islands
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Western Sahara
Yemen
Zambia
Zimbabwe
What is your purpose for enrolling at The Exodus Academy?
What School are you registering for?
*
Exodus Foundation (prerequisite)
School of Healing
School of the Supernatural
The School of Prayer
Leadership in Ministry
Understanding Biblical Intelligence
Developing The Fruit of the Spirit
What do you hope to gain from being a student at The Exodus Academy?
Are you a part of a church?
Yes
No
If yes, what is the name of your church?
Do you play a role in church or serve in any ministry?
Yes
No
If yes, please explain
What are your ministry gifts?
Preferred method of contact
Phone
Email
How did you hear about us?
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