The Harbor - Small Group Leader Interest Form

First Name

Last Name

Email

Phone Number

Age

How long have you attended The Harbor?

What city do you live in?

Marital Status

Married and will be leading a group with my spouse

Married and will be leading a group on my own

Single

Separated/Divorced

Widowed

Spouse's Information (if applicable)

Spouse's First Name

Spouse's Last Name

Spouse's Email

Spouse's Phone Number

Spouse's Age

How often can you lead a group?

Weekly

Bi-Weekly (twice a month)

Are you able to host a group in your home?

Yes

No

What day of the week would you like to lead a group?

What would the focus of your small group be? (For example: empty-nester couples, young couples, women only, etc.)

Why are you interested in leading a small group?

Small Group Leader Interest