Group Placement Form

Group placement

Please fill out this form to help us get to know you so we can place you well within a group.

* Indicates required field

Name *

First

Last

Email *

Spouses Name (if registering as a couple) *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number (best) *

Age Range *

18-25 25-29 30-39 40-49 50-59 60-69 70+

Type of group you prefer: *

married couples men women co-ed (single or married and either gender)

How do you prefer your group to meet? *

virtually in-person combination of virtual and in-person no preference

Which day(s) DO NOT fit your schedule? (select all that apply) *

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

What time(s) of day best fit your schedule? (select all that apply) *

morning afternoon evening

Do you have children? (living at home with you) *

If so, please list their name, gender and age below *

What is the most important thing to you when selecting a small group? *

close to me (location) similar stage of life people my age

Would you be interested in leading a group or to learn how to lead a group? *

Yes, I am interested in leading a group. Yes, I am interested in learning how to lead a group. Not at this time.

Have you been in a group before? *

Are you signing up with someone else (not including spouse and children)? If so, please list their name(s) below. *

Comment *

Submit