Samuel Group l Diocese of Erie l 2022-2023
PLEASE COMPLETE THIS FORM IF YOU ARE INTERESTED IN JOINING THE GROUP AND WE WILL CONTACT YOU WITH MORE DETAILS. For more information visit erie.org/youth or email firstname.lastname@example.org.
Date of Birth
Cell Phone Number
Please enter a valid phone number.
Address (Work or Home address will help us assign the closest available spiritual director if you do not currently have one)
Street Address Line 2
State / Province
Postal / Zip Code
What is your current vocational status?
What is your religious affliation?
Do you have children?
Do you have a spiritual director already?
If "yes," are you finding your spiritual direction appointments helpful?
Are you currently working?
If "yes," what is your current occupation?
Are you a college student?
If "yes," what institution do you attend?
When is the best time to reach you for a quick video interview? (15-20 mins)? Please check all that apply:
What does it mean for you when you hear, “Discerning your vocation?"
What is your goal or hope in attending the Samuel Group?
How did you hear about the Samuel Group?
Referred by a team coordinator, Fr. Mike, or Jillian
I am committed to...
Small group sharing
Attending all the sessions
Having spiritual direction once a month
If “no” to any of the options above, what obstacles do you have to committing?
Should be Empty:
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