Life Group Leader Application

1
What is your full name?* This field is required.
First Name
Last Name
2
What is your street address?* This field is required.
Street Address
Street Address Line 2
City
Please Select
Please Select
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
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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
3
What's your email address?* This field is required.We'll use this to get back to you. No spam or unexpected newsletters here.
example@example.com
4
What is your mobile phone number?* This field is required.
5
What is your date of birth?* This field is required.This information is kept confidential.
Date
Year
Month
Day
6
Please check all that apply:* This field is required.
I have finished Next Step
I have finished Pathways
I have finished Foundations
I have not taken Next Step, Pathways or Foundations
7
Did you sign up for a ministry during Next Step, Pathways or Foundations?* This field is required.
YESNO
8
Did you complete a background check within the last year?* This field is required.
YESNO
9
What community will your Life Group be held in?* This field is required.ex. "Mattapan, Dorchester, Milton, Randolph, Stoughton, Brockton"
10
What day of the week will your Life Group meet?* This field is required.
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
11
What is the projected start date your Life Group will meet?(If known)
Date
Year
Month
Day
12
Approximate start time your Life Group will meet:
Please Select
Please Select
5:00 am
5:30 am
6:00 am
6:30 am
7:00 am
7:30 am
8:00 am
8:30 am
9:00 am
10:00 am
10:30 am
11:00 am
11:30 am
12:00 pm
12:30 pm
1:00 pm
1:30 pm
2:00 pm
2:30 pm
3:00 pm
3:30 pm
4:00 pm
4:30 pm
5:00 pm
5:30 pm
6:00 pm
6:30 pm
7:00 pm
7:30 pm
8:00 pm
8:30 pm
9:00 pm
Option 3
13
How often will your Life Group meet?* This field is required.
Weekly
Every Other Week
Monthly
14
Are Children welcomed to attend?* This field is required.
YESNO
15
What type of Life Group will you start?* This field is required.
General
Coed
Married
Men's
Women's
Young Adult
Outreach
Prayer
Sports
Service
Other
16
Target Age Range:* This field is required.
11-14 (middle school)
14-18 (high school)
18-29
30-39
40-49
50-59
60 and up
17
Do you want your Life Group listed on jubileeboston.org?* This field is required.If "no" is selected, you will not receive any prospects from jubileeboston.org signups
YESNO
18
Describe your group for the web listing (Why would someone want to join your Life Group?)* This field is required.Example: "We are a group of men & women in our 30-40s who meet once a week to share life experiences and have fun playing board games"
Huge
Large
Normal
Small
Ok
Ok
19
Which campus do you regularly attend?* This field is required.
Boston
Stoughton
Worcester
20
Please upload a photo of yourself: * This field is required.Be sure to crop the photo if necessary so that your face can be seen
Should be Empty: