Small Group Sign-Up

Small Group Sign Up
Name

First Name Last Name
E-mail
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
If you are currently in a Small Group:

I'd like to stay in my current small groupI'd like to switch it up and change groups this time around
When would you be available for Small Group? (check all that apply)

Mon AMMon PMTues AMTues PMWed AMWed PMThurs AMThurs PMFri AMFri PMSat AMSat PMSun AMSun PM
What is your Current Life Stage

SingleMarriedMarried with children
Please number the different groups based off your preference. 1 being your first pick.

Example: Your first choice would be to be in a similar stage group, so you'd put a one and the multi-generational would be your last, you'd put 3.
Similar Life Stage Group
Same Sex Small Group
Multi-Generational Small Group
Will you need childcare?

YesNo
Please place me with:
Would you be willing to Facilitate a Small Group?

YesNo
Would you be willing to Host a Small Group?

YesNo
Any additional comments or questions?
Should be Empty:

Small Group Sign Up