Spring 2018 Small Group Registration Form
Have you attended Small Group Leadership training? *
Have you previously led a Small Group at South Coast Church? *
You are submitting your Small Group Application for: *
First Name: *
Your answer
Last Name: *
Your answer
Email Address: *
Your answer
Phone Number: *
Please include area code
Your answer
Birth Date *
MM
/
DD
/
YYYY
Gender: *
Marital Status: *
If engaged or married, please indicate the name of your significant other:
Your answer
Children's names and ages:
If applicable
Your answer
Co-Leader (please put "NONE" if not applicable): *
First and Last Name
Your answer
Co-Leader email address (please put "NONE" if not applicable): *
Your answer
Small Group Name *
Your answer
Small Group Hub: *
Select All That Apply
Required
Type of Group *
Small Group Age Range: *
Select All That Apply
Required
Small Group Meets On: *
Time *
Please specify a start and end time (ex: 5:00pm - 6:30pm)
Your answer
Small Group Description *
Brief 2-3 sentences
Your answer
Small Group Location: *
Street Address
Your answer
City: *
Your answer
State: *
Your answer
Zip Code: *
Your answer
Are you providing child care? *
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