Discipleship Group Signup First Name (required) Last Name (required) Your Email (required) Cell Phone Other Phone Age Group (required) 18-2526-2930s40s50s60s70s+ Address (required) City (required) State (required) Zip (required) Marital Status (required) MarriedDivorcedWidowedSingle I would consider hosting a Discipleship Group in my home: YesNo I am available during any of the following time slots: (check all that apply) (required) Sunday MorningMonday EveningTuesday EveningWednesday EveningThursday EveningFriday Evening Which best describes your stage of life? (required) single young adultyoung marriedyoung familyparent(s) of teen(s)mature singleempty nestersenior Which type of group would you prefer? men onlywomen onlycouplesunmarriedmixeddoesn't matter On a scale from 1 to 5, where 1 means "not important" and 5 means "very important", how important is: Having a discipleship group close to your home? 12345 Having a discipleship group with others of like state of life? 12345 Having a discipleship group of same gender/marital status? 12345 Other information that might assist us in assigning you to a group: Please note: We attempt to place everyone into groups as quickly as possible, however, due to circumstances such as the number of people requesting to be put into groups and the number of open/matching groups available, it can occasionally take additional time to get you placed. Please feel free to call the church at 805-238-4419 at any time to inquire about your placement.