Name *

First Name

Last Name

Phone

(###)

###

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Would you prefer in-person, virtual, or hybrid meetings? *

In-Person

Virtual

Hybrid

Would you be interested in leading or co-facilitating discussions?

Yes

No

What genre of books are you most interested in reading? (Select all that apply)

Fiction

Non-fiction

Memoirs/Biographies

Self-help/Personal Development

Social Justice/Activism

Inspirational/Spiritual

Other