WCC Men's Community Winter 2.0 2021

Registrant

First Name

Last Name

Mobile

Address

Are you currently in a Men's huddle group?

If yes, who is your huddle leader? (Please list N/A if you don't remember.)

The cost for this study is $20, which must be paid via credit or debit card on the next screen. If the cost is an obstacle to your attendance, please contact Brandon Reynolds at brandonr@willamette.cc.

If you would like to fund a scholarship, please choose from the options below and they will be added to your total on the final page.

Would you like to fund a scholarship?

Half Scholarship ($10.00)

0

Full Scholarship ($20.00)

0

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