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First Name *

Last Name *

Phone Number *

E-Mail *

City & State of Requested Location *

Desired Workshop * A Real Man’s Power WorkshopUnexpected Lessons Learned by a Lawyer WorkshopBuilding a Better Community WorkshopThe Soul of You WorkshopsOther

Desired Workshop Date *

Number of Potential Attendees * 5-1011-1516-2020+

Special Requests