Discipleship Group Sign Up 2011 - 2012
Student's First Name:
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Student's Last Name:
*
Student E-mail:
*
Parent E-mail:
*
Home Phone:
*
Cell Phone:
*
Address:
*
City:
*
Zip code:
School:
Grade entering in '11-'12:
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9
10
11
12
List 1 - 3 students you would like to be in a group with
(Note: we do our best to fit students into groups with
their friends but cannot guarantee you will be in a group
with everyone you request.)
....
List any other personal request you may have for a group
(i.e. day of the week, location...)
....
By entering the code below, I am acknowledging that I have
read the information provided above about Discipleship Groups
and the D-Group Commitment and I am interested in joining a
Discipleship Group for the upcoming school year '11-'12.
Validation Text:
*
Submit
Should be Empty: