Name:
Address:
City:
ZIP:
E-Mail:
Phone Number:

Preferred Small Group Type:

Interests (choose 1 or more)
50+ (years old) group
Bible study
Celebrate Recovery
Kid friendly
Marriage group
Men's group
New believer's group
Single's group
Widow and widower group
Young adult's group (18-24)

Other Interests:

Day Preference (choose 1 or more)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Time Preference (choose 1 or more)
Morning
Afternoon
Evening

City Preference (choose 1 or more)
Chandler/Gilbert
Mesa
Phoenix
Scottsdale
Tempe