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Full Name
*
First Name
Last Name
Email Address
*
Phone Number
*
Format: (000) 000-0000.
What age group do you fall into?
20's
30's
40's
50's
60's
70's and beyond
What best describes where you are at on the spiritual map?
Unsure about God or faith, but curious and open to discussing.
Believer, but not attending church currently.
Growing Christian, but desiring even more for relationship with God.
Other
If you attend church, it is at Holy Ghost & St. Bernadette?
Yes
No
Do you have any dietary restrictions or allergens that we should know about?
Please list them above
Do you have someone you would like to be in a small group with? (Fill in name)
Limited childcare is available for our Holy Ghost & St. Bernadette Alpha participants on Monday nights. Will you need childcare?
*
Yes
No
If needing childcare, please list names & ages of children.
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