EmailMe Form - Small Group Leader Form

Name of Small Group *

Leader of Small Group *

Leader 2

First Last

Only fill out if applicable.

Leader 3

First Last

Only fill out if applicable.

Leader 4

First Last

Only fill out if applicable.

Main Contact Person *

Email *

Contact Phone *

### - ### - ####

Phone numbers & emails of other leaders.

Only fill out if applicable.

Do you have a host home / location? *

Yes

No

The church is no longer available on Wednesday evenings - our facilities are being used by our youth & kids ministries. If you are needing to use the church on a different day, it must be approved by Pastor Richie 3 first. The church is reserved on a first come first served basis.

Host Home Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Only fill out if this is the location you'll be meeting.

Meeting Day *

If you need childcare for your group, please note that it is provided only on Tuesdays & Wednesdays!

Meeting Time *

Frequency of Meetings (weekly, once, or twice a month?) *

Brief Description of Group (including if it's a men's, women's, or co-ed group). *