Discipleship Group Interest Form

Birthdate

Gender

Marital status

I regularly attend... *

Select all that apply

The 9

The 11

Other

I am looking to... *

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Join an existing Small Group

Join a new Small Group

Start a new Small Group

Lead a new Small Group

I am looking for... *

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Anything

Dating Couples

Men Only

Married Couples

Mixed Group

Senior Adults

Singles

Women Only

Young Adults

Young Families

Other

I would love to get this out of being in a Discipleship Group: *

Please describe what you'd like to see happen in your time in the group. Some examples include community or spiritual growth.

Is there anyone you'd like to join with you, or a group of people you want to be grouped with? If so, please list names below:

Phone number *