Small Group interest Form Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Date of Birth * MM DD YYYY Gender * Male Female Marital Status * Single Married Separated Divorced Widowed Tell us a little bit about yourself and the type of group you would like to join. Type of Small Group * Co-Ed Male Female What days are best for your schedule? (Please only select a max of 3 days) * Sunday PM Monday AM Monday PM Tuesday AM Tuesday PM Wednesday AM Wednesday PM Thursday AM Thursday PM Friday AM Friday PM Saturday AM Saturday PM If applicable, will your spouse attend the same group? If applicable, number of and age of children that will be attending with you. Are you interested in leading a group? Yes No Are there any additional questions or thoughts that will guide us in helping you find a group? Thank you!
