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Name*
First Last
Birthday*
MM
DD
YYYY
Email*
Phone*
Address*
Street Address City State ZIP Code
What leadership roles have been important in your life experience? What personal gifts do you bring to leadership?*
In what ways would you like to grow as a leader?*
In what ways are you currently nurturing your spiritual growth?*
Scholarships are available. If you are interested in a scholarship please explain your need.*
Parish(es)
note: belonging to a parish is not required to participate in the Institute.

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