1nC Discussion Group Questionnaire
We are excited to have you participate in this discussion opportunity. In order to match you with someone in the fellowship we need the following information. If you are filling this form out with your spouse please fill out two separate forms. You will be given the option to submit another form at the end. Thank you!

Disclosure: Responses from this questionnaire will not be shared. Your discussion partner will only know your name and a way to connect with you for the conversation. This questionnaire is for GPCC members only.
Email address *
First *
Last *
Phone *
Gender *
Age *
Are you of Hispanic or Latinx origin? *
How would you describe your race? (check all that apply) *
Fellowship Region *
Where do you currently live? *
Married or Single *
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