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Complete this form and show your confirmation email to a Pioneer Bible Translators representative at this event.

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Name(Required)
Church Position(Required)

Home Address(Required)
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Set this under Advanced > Default Value. This field will populate in the notification email(s).
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Enter Segment Name in the Default Value field. i.e. MPE-E2407 Free Book E4 Conference
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Set the Default Value of the Contact Note hidden field below to what the Virtuous Contact Note should be when the contact is created or updated from this form. The contact note template is: [Virtuous Tag Name] — [Book or Gift Name] For example: CHP-E2403 Free Book National Preaching Summit — Extraordinary Hearing
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How will they receive their book?(Required)
Set this under Edit Choices and check the default option. This choice determines which notification email the person will receive.