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Thank you for taking the time to register your Connect Group!
To make sure we have the most accurate information, please fill
out the form completely.
Leader Name (First, Last):
Leader E-mail Address:
Leader Phone Number:
Home Phone
Cell Phone
Work Phone
Leader Mailing Address (Street, City, Zip Code):
This address will not appear in the online search--only the city you meet in.
Group Meeting Address (If different from mailing address):
Month/Year of Group Start (Approximate is fine!):
Is Your Group Open or Closed?
Open
Closed
Type of Group:
You will have the ability to specify more details about who your group is made up of once you begin using Groups On-line. For now, if your group is not specifically for men, women, or college students, please select "Everyone Welcome".
Everyone Welcome
Men's
Women's
College
Campus:
Herndon
The Plaza
Waterford
Day Group Meets:
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Time Group Meets:
If your group has a co-leader(s), please fill out the following section.
A co-leader will have the ability to manage group details.
Co-Leader 1 Name (First, Last):
Co-Leader 1 E-mail Address:
Co-Leader 1 Phone Number:
Home Phone
Cell Phone
Work Phone
Co-Leader 2 Name (First Last):
Co-Leader 2 E-mail Address:
Co-Leader 2 Phone Number:
Home Phone
Cell Phone
Work Phone
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