The Common Network Profile Information

Please fill out this form and click submit.

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This form cannot be submitted until an administrator completes the setup process to receive online payments.

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Age Range

*

Please select one option.

under 18 18-25 26-35 36-50 50+

Gender

*

Please select all that apply.

Male Female

Occupation/School

*

Schedule/Availability (ex. flexible, only on weekends, etc.)

*

Communication preferences (select all that apply)

*

Please select all that apply.

Email Text Phone Call

Are you joining The Common in connection with a church, school, or business?

*

Why do you want to engage the refugee community of OKC?

*

Please list Special skills/interests/experiences related to The Common

*

Reference #1: Please list name, email, phone, and connection to participant

*

Reference #2: Please list name, email, phone, and connection to participant

*

Payment

Background ($19.00) none ($0) other amount

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

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