Prairie Lakes Church | Join A Group

SMALL GROUP INTEREST
Want to choose your own group? Check out our small group directory here.
Personal Information
Full Name*

First NameLast Name
Which campus do you attend?*
please select one
Type of Group [select all that apply]

Adult Small GroupWomen'sMiddle SchoolHigh SchoolCollege
Birth Date*

MonthDayYear
Gender*
Marital Status

SingleMarriedSeparatedDivorcedWidowed
Will your spouse be attending the group with you?

YesNo
Spouse's Full Name

First NameLast Name
Spouse's Birth Date

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number

Area CodePhone Number
Cell Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Names of Children at Home and ages:
Availability
Availability

Sunday AMSunday PMMonday AMMonday PMTuesday AMTuesday PMWednesday AMWednesday PMThursday AMThursday PMFriday AMFriday PMSaturday AMSaturday PM
I absolutely cannot meet:
Any additional notes:
Should be Empty:

SMALL GROUP INTEREST