STATEMENT OF FACTS



   I, hereby certify that I am the individual named below and will  
provide identification to confirm my true identity.  I also hereby
certify that I am not misrepresenting my intentions or purpose
for participation in serving Community Service through Grace
Bible Center.
Your name:
Your email address:
YOU WILL NEED TO PRINT OUT THIS
PAGE AND BRING IT WITH YOU
ONCE ACCEPTED.  WE SUGGEST
YOU PRINT THIS PAGE NOW!
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