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event 112
Registering for
event 112
— $45
Basic information
First Name
Last Name
Preferred pronouns
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She/Her
He/Him
They/Them
Ze/Zir
Something else
Email address that you check regularly
Mailing address
Telephone number
Do you use WhatsApp?
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Hindu
Agnostic
Atheist
Bahai'i Faith
Buddhist
Christian - Catholic
Christian - Protestant
Indigenous Traditions
Jain
Jewish
Mormon
Muslim
Pagan/Wiccan
Quaker
Sikh
Unitarian/Universalist
Zoroastrian
Something else
Unaffiliated
Primary role in spiritual care
Chaplain/Spiritual Caregiver
Chaplaincy student (degree, certificate program or chaplaincy courses)
Places of employment and/or study
Employer Name / Affiliated Organization
Job Title
Full Time/Part Time/Volunteer
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Full Time
Part Time
Volunteer
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How did you hear about NAHCA?
CIF Spiritual Care course
GTU
Chaplaincy Innovation Lab
Divinity School (please specify which one)
Word of mouth
Google search
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Continue to Payment — $45
