Small Group Placement Form

Phone number *

Birthdate

What is your primary campus *

What days of the week are you interested in? *

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Who will be attending? *

Myself

Myself & Spouse

If you have children (ages 0-14) please indicate their ages here

Which groups best applies to you? (Check all that apply) *

Young Adult (18-30)

Engaged / Young Married

Family (with children birth-preschool)

Family (with children elementary age)

Family (with teens)

Empty Nest (working)

Empty Nest (retired)

Men's Group

Women's Group

Other

What city do you prefer to meet in?