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.

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