LIFE GROUP FORM

Please complete the form* below if you are interested in joining or facilitating a LIFE group. 
(*this is an unsecured form, you may print and submit this form at church if you prefer) 

Contact Information:
Name:  
     
Address 1:  
     
Address 2:  
     
City:  
     
State:  
     
Zip:  
     
Home Telephone #:  
     
Work Telephone #:  
     
Cell Phone #:  
     
E-Mail Address:  
     

Best times for you to be in a LIFE group (check all that apply):
Days:   M   T   W   TH   F   SA   SU
 
Evenings:   M   T   W   TH   F   SA   SU
 

LIFE group interest categories (check all that apply):
  Bible Study/Growth   Prayer   Evangelism/Outreach
 
  Fellowship/Service   Transitions   Christian Cancer Survivors
 
  Men's   Women's   Young Adult
 
  60+   Couples   B.A.S.I.C. (Brothers and Sisters in Christ)
 

Other factors you consider important:

(e.g. life stage/situation, location, childcare, want to learn about leading a small group)
 
431 W. Austin Ave. | Libertyville, IL 60048 | 847.362.8155 |