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1
Name
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Fill in your first and last name below.
First Name
Last Name
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2
Date of birth
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Date
Month
Day
Year
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3
Email
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example@example.com
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4
Phone Number
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5
Address
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
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Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
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Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
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Denmark
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Maldives
Mali
Malta
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Mayotte
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Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
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Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
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Saint Vincent and the Grenadines
Samoa
San Marino
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Senegal
Serbia
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Sierra Leone
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Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
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Sudan
Suriname
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eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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6
Your Parish
*
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7
Are you already in a men’s group?
*
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Yes
No
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8
Have you been in a men’s group before?
*
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Yes
No
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9
You are interested in:
*
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Joining an existing group but don’t want to facilitate one.
Starting and facilitating a new men’s group.
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10
Check all the days of the week that work for you to meet:
*
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Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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11
Check all the times of day that work for you to meet:
*
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Morning
Afternoon
Evening
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12
What do you hope to give / get from this group? Rank level of importance to you:
*
This field is required.
Vital
Important
Less important
Camaraderie and Fellowship
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Spiritual growth
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Developing a relationship with other Catholic men
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Ability to meet others who can hold me accountable
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Learn more about my faith
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Become a better man and/or husband and/or father
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Develop self and spiritual discipline
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Camaraderie and Fellowship
Spiritual growth
Developing a relationship with other Catholic men
Ability to meet others who can hold me accountable
Learn more about my faith
Become a better man and/or husband and/or father
Develop self and spiritual discipline
Vital
Row 0, Column 0
Important
Row 0, Column 1
Less important
Row 0, Column 2
Vital
Row 1, Column 0
Important
Row 1, Column 1
Less important
Row 1, Column 2
Vital
Row 2, Column 0
Important
Row 2, Column 1
Less important
Row 2, Column 2
Vital
Row 3, Column 0
Important
Row 3, Column 1
Less important
Row 3, Column 2
Vital
Row 4, Column 0
Important
Row 4, Column 1
Less important
Row 4, Column 2
Vital
Row 5, Column 0
Important
Row 5, Column 1
Less important
Row 5, Column 2
Vital
Row 6, Column 0
Important
Row 6, Column 1
Less important
Row 6, Column 2
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13
We want to hear from you, what are some of your expectations, questions and/or concerns when considering joining? Or what else do you want us to know about you?
*
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14
Is your men’s group open to additional members?
*
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Yes
No
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15
Who is in your men’s group?
Please add first and last name
First Name 1
Last Name 1
First Name 2
Last Name 2
First Name 3
Last Name 3
First Name 4
Last Name 4
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16
What day of the week does your men’s group meet?
*
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Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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17
What time does your group meet?
*
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Minutes
AM
PM
AM
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PM
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18
How often do you meet?
*
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Weekly
Bi-weekly
Monthly
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19
Do you know of another man you’d like to invite or would benefit from Warriors of St. Michael?
*
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YES
NO
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20
If yes, would you share their contact information? We’d love to include them in our next meeting.
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21
What’s working well with your men’s group? And/or what do you think could be better?
*
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22
Is there anything else you’d like us to know about your men’s group or ways we could support you?
*
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