SMM-Small Groups-Registration

Small Group Registration

Small Group Information

Group Placement Request Form

We're glad you're interested in joining a group! Please fill out the form below and we'll get back you as soon as possible.

My Information

First Name*

Last Name*

Age

Gender

Female Male

Street Address*

City*

Zip Code*

Phone (###-###-####)

Email Address

I prefer to be contacted by:

Phone Email Text Postal Mail

Help Us Find the Right Group For You

What type of group are you looking for?

Married Couples Mixed Adult (Men & Women) Men Only Women Only Spanish Speaking Retirees

Which days fit your schedule? Select all that apply.

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Which times of day best fit your schedule? Select all that apply.

Morning Afternoon Evening

I would like to learn more about leading a Small group? Yes
No

Have you been in a group before? Yes
No

Comments or Questions

Retype the characters from the picture: