Name *

First Name

Last Name

Phone *

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Please Check ALL That Apply *

I am interested in becoming a SMALL GROUP FACILITATOR/LEADER.

I am interested in being a HOME HOST.

My home is available for all FALL 2025 session dates Sep 21, Oct 5, Oct 19, Nov 2, Nov 16]

My home is available for some sessions, but not all.

My home is not available. (I am willing to lead but not in my own home.)

YES, I can attend the REQUIRED leader training session scheduled for Sunday, August 17 @ 6:00pm

I will not be able to attend the leader training session on Sunday, August 17 & will need to schedule an alternative date/time.