EGroup Leader Application
Leader Information
Group Leader Full Name
Your answer
Group Leader Email
Your answer
Group Leader Phone Number
Your answer
Co-Leader Name
Your answer
Co-Leader Email
Your answer
Have you gone through the complete EQUIP process?
Group Name
Your answer
Group Information
Group Meets On...
Group Start Time?
Time
:
Group End Time?
Time
:
Meeting Address
Please include complete address - including zip code.
Your answer
Meeting Place
ex: The Smith Residence
Your answer
Group Description
1-5 sentences that capture the vision of the group.
Your answer
Group Requirements
Your answer
Age range of group?
Required
Will childcare be provided?
Group Category
Group Secondary Category
Curriculum Title (if applicable)
Your answer
Curriculum Author (if applicable)
Your answer
Comments or questions?
We'd love to address them!
Your answer
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