PREPARED New Group Interest Form

New Group Interest Form

Please complete this form to start a new PREPARED cohort with your group exclusively. One of our program staff will be in contact with you momentarily with more details.
- Name*
  
  First NameMiddle NameLast NameSuffix
- Title*
- E-mail*
  example@example.com
- Phone Number*
- Organization or Group Type*
  
  Fraternity or SororityChurchCommunity Based OrganizationSmall GroupOther
- Name of Fraternity or Sorority you are associated with.
- What is the make up of the group you want the program to serve?*
  
  Singles (no partner or dating)Couples (engaged or married)Both Singles & Couples
- # of Singles you have to participate*
- # of Couples you have to participate*
- Do you currently offer marriage or relationship education or activities to your group?*
  
  YesNo
- Would you be interested in having your group partner with another group to participate in the program?*
  
  YesNo
- Please write any additional information we should be aware of
- By submitting this from, you are agreeing to be contacted by RTV staff and representatives via email and/or phone in relation to organization wide information.
- I acknowledge and agree to the terms*
  
  Yes
- Should be Empty: