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Small Groups Registration Form
Small Groups Registration Form
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Your Information
First Name
(required)
Last Name
(required)
Email Address
(required)
Occupation
Phone Number
(required)
Best Time to Call:
Daytime
Evening
Age Range:
18-24
25-34
35-44
45-54
55-64
65+
Marital Status:
Single
Married
Divorced
Children:
Yes
No
If yes, please list names and ages:
Small Groups Information
I am registering for the following groups.
Please check all that apply.
CO2 - Church of 2
FM - Family Matters
LSG - Life Stage Group
I am interested in the following type(s) of groups.
Please check all that apply.
Mixed
Singles
All Men
All Women
Couples / Families
I have the following meeting preference(s).
Please check all that apply.
Weekends
Week Nights
Once a week
Once Every Two weeks
If possible, please provide specific meeting times that work for you:
Would you be interested in facilitating?:
Yes
No
Would you be interested in hosting?:
Yes
No
Required Fields