Feedback Form and Royalty Fee
Course offerend
Discern
Engaged
Sponsor
Newlywed
Fertility
Marriage Kit
BreakThrough (SLBT)
Theology
Other
How many couples (or spouses for SLBT) ENROLLED in your group experience?
*
How many couples (or spouses for SLBT) COMPLETED your group experience?
*
Gathering location
Church venue
Public venue (eg cafe)
Workplace
Home
Online
Other
Feedback
We'd love to hear your feedback and suggestions as well as any details around how you ran the event
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Full Name
*
Prefix
First Name
Last Name
E-mail
*
example@example.com
Your Organisation
*
Phone Number
*
Your Diocese
*
Location
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
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American Samoa
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Anguilla
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Botswana
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Fiji
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Hungary
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India
Indonesia
Iran
Iraq
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Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
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North Korea
South Korea
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Laos
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Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
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Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
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Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Royalty contribution
A royalty to support SmartLoving’s ministry is requested for each Participant in the Plug & Play format. Suggested amount is $5AUD per couple (or spouse for SLBT). If you are from a disadvantaged community, please adjust your contribution according to your means. If you cannot pay via credit card please use EFT (Marriage Resource Centre | BSB 082 057 | Account 13 515 3653).
Payment Method
*
Credit Card (preferred)
EFT - Make your transfer and email the details
Total Contribution
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AUD
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