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HOME
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JOIN A LIFE GROUPS
JOIN A LIFE GROUPS
Please complete the following
:
(Note: Fields marked with an asterisk are required.
)
FIRST NAME:
*
LAST NAME:
*
ADDRESS:
*
CITY:
*
STATE:
*
ZIP:
*
PREFERRED LOCATION
OF THE LIFE GROUP:
PREFERRED DAY OF
THE WEEK :
Please select
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
PREFERRED TIME OF
DAY :
Please select
Morning (8 - 10AM)
Mid-Morning (10 - 12PM)
Noon (12 - 2PM)
Mid-Afternoon (2 - 4PM)
Late Afternoon (4 - 6PM)
Evening (6 - 8PM)
Late Evening (8 - 10PM)
Other
HOME PHONE:
*
WORK PHONE:
CELL PHONE:
EMAIL:
*
GENDER:
MALE
FEMALE *
DATE OF BIRTH:
MARITAL STATUS:
CHILDREN & AGES:
DESIRE TO BE A
LIFE GROUP COACH:
Life Coach Requirements
Pastor Edward A. Smith
Whittier Church
Christian Fellowship
Missionaries in Africa