Name *

First Name

Last Name

Phone

(###)

###

####

Preferences *

Our goal is to provide as many opportunities as possible for you connect in the way you prefer. We are in constant prayer that God will place you in just the right group with just the right people. Feel free to let us know your preferences for connecting below. We will do our best to provide what you are looking for, but do ask that you be in prayer and open to the opportunities that arise.

I have no particular preferences about the type of Small Group.

I would like to be part of a Women's only Small Group.

I would like to be part of a Men's only Small Group.

I would like to be part of a Co-ed Individuals Small Group.

I would like to be part of a Couples Small Group.

I would like to be part of a Small Group with others who have children.

I would like to be part of a Small Group with others who do not have children.

I would like to be part of a Small group with others in my age group/stage of life.

I would like to be part of a Small group with others who live close to me.

I am limited to meeting certain days/times during the week.

If you are interested in joining a group with your spouse, please tell us their name:

First Name

Last Name

If you are interested in joining a group with others who have children, please tell us your child(ren)'s age (check all that apply):

Birth - Age 2

Age 3 - Kindergarten

K-5th Grade

6th-12th Grade

If you are interested in joining a group with others in your age range/stage of life, please provide your birthday:

MM

DD

YYYY

If you are interested in joining a group with others who live close to you, please provide your address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country