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Community Group Interest Form
Please let us know about you so that we can connect you to the right Community Group.
Your name
*
Last name
Email address
*
Phone number
Phone type
Mobile
Home
Work
Other
Birthdate
Date
Address
Home
Work
Other
Country
Country
Street address
Apt/unit/box (optional)
City
State
Postal code
Household members
+ Add adult
+ Add child
Do you have children that will need childcare?
*
Yes
No
What nights of the week fit your schedule?
*
Check all that apply
Monday
Tuesday
Wednesday
Thursday
Is there anyone in our church that you already know? If so, what is their name(s)?
Have you ever been convicted of a violent criminal act and/or sex related crime?
*
Yes
No
Questions/Comments
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