Name of the Primary Contact *

Who is the best person for the Connections Pastor to communicate with about your group?

First Name

Last Name

Primary Contact's Phone *

(###)

###

####

What is the primary contact's preferred form of contact? *

Please check the best way to reach you about your group.

Email

Text

Phone

What time will your group be meeting? *

Hour

Minute

Second

AM PM

When do you anticipate your group to begin? *

MM

DD

YYYY

Is your group open or closed?

My group has reached its maximum capacity and is now Closed to new members.

My group is open to new members joining.

For what ages/genders are your group appropriate?

Some groups discuss subjects that may be inappropriate for certain ages/genders to be a part.

All Ages/Genders.

Children (0-11)

Students (12-18)

College (18-24)

25-35

36-49

50-65

66-80

81+

Male

Female