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  Dear Friends,


The purpose of this form is not only to get to know you before we grant you a password to our website, but to also be able to serve you better. Therefore we ask you to please put your real info, with the exception of your name which is your choice to put it or not.

We also promise you, that this info is going to be strictly confidential, and will never be shared with anybody out side Alaberoon team.

  Notes: filed with * it means Required

Real Name (optional)
*Nick name/screen name
*Age group
Country where you were born

Country where you live right now


*E-mail Address


You can send me communications on this e-mail    

Please DO NOT send me communication on that e-mail

Phone number you can receive calls on (if available)

*Languages spoken
Social Status
How many kids if any?
Any other believers in your family?

Yes       No

If yes, how many?  

My job is in the area of (you don’t have to e specific just general)


Example; you work in a hospital or doctor’s office for paper work ( medical field)

*How long have you been a follower of Jesus?
*I came to Jesus through

*My biggest goal/ challenge at the time being would be

(choose only 3)

To grow with Jesus

To finish reading the entire Bible

To find a job

To find a church

To get Baptized

To find a life partner

To leave my country to a safer place

To share my faith with my family

*Write your story briefly

( minimum 100 words,

 no maximum)


Enter book Name as shown on Episode and Your mailing address

Book Name


Mailing Address

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