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Discipleship Training Group Application

Name(Required)

First Last

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email (If you have one)

Way to contact you if you don't have a phone or e-mail:

This could be a parent's phone number or e-mail:

Home Church (Put N/A if you do not have one) :(Required)

12 week Discipleship Group you would prefer to be in:(Required)

Monday Nights from 8-9:15PM

Tuesday Mornings from 6-7:15AM

I would attend either one!