Groups

Divorced / Separated

A Buckhead Church Group

In Person I Divorced I Thursdays @ 7pm

Tell us about yourself

First Name *

Last Name *

Gender *

Date of Birth *

Marital Status *

Church you attend *

Email *

Email confirmation *

Phone *

Would you like to opt-in for Text Reminders?

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Street *

City *

State *

Zip *

Do you have children? *

Is your divorce final? *

If yes, what was your divorce date?

If no, how long have you been separated?

What is your ex-spouse's name?

Payment Information

Amount to be Charged:

$10.00

Cardholder name

Card #

Expiration(MM/YYYY)

CVV

Postal Code

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