Life Group Interest Form

Address

Phone number

Primary campus

Life Stage and Family Information

Young Single Adult

Young or Newly Married

Married without children

Divorced/Separated/Widowed

Young Family

Blended Family

Empty Nester

Retiree

What type of group are you interested in joining?

Men

Women

Couples

Mixed (Couples and Singles)

Single Adults

I am available to meet on:

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

I am NOT available to meet on:

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

My experience with groups is (check any that may apply):

This is my first group experience at Daybreak Church

I have previously been in a group at Daybreak Church

I have previously led a group at Daybreak Church

I have participated in a church group outside of Daybreak Church

I have led a church group outside of Daybreak Church

Any other information that you wish to share: