Summer 2015 Connect Groups — influencers

Connect Group Name *

This is how your group will be identified on all flyers, on-line, etc.

Day of the week Group meets *

Start Time *

Start Time

Hour

Minute

Second

End Time *

End Time

Hour

Minute

Second

Group Description *

Location Name

Describe where the group meets

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Leader Name *

Leader Name

First Name

Last Name

Leader Phone *

Leader Phone

(###)

###

####

Co-Leader 1 Name

Co-Leader 1 Name

First Name

Last Name

Co-Leader 2 Name

Co-Leader 2 Name

First Name

Last Name

Attendees *

Children Welcome? *

Age Group *