I want to
HOST a group in my home
I would just like to attend a group.
I would like to LEAD a group.
I would like to be a "leader in training" and lead a group in the future.
I WANT TO JOIN A HOME GROUP
SIGN ME UP!
Full Name
*
First Name
Last Name
Full Name
*
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
City
Province
Postal Code
Preferred Day(s)...
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
I live in or nearest to ...
Yorkton
Melville
Springside
Canora
Willowbrook
Ebenezer
Saltcoats
I prefer a group that is...
Couples
Singles
Families with young children
Women
Men
No preference
Age Category
18-30
30-40
40-50
50+
Comments / Requests
Is there a specific group or person you would like to be placed with? If so, please indicate & we will do our best to accommodate you!
SUBMIT
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