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Connect Leader Interest Form
Thank you so much for your interest! Please fill out this form, and Emily will reach out to grab coffee or lunch soon. If you're unsure about any answer, feel free to leave blank and discuss with Emily.
Your name
*
Last name
Email address
*
Phone number
*
Phone type
Mobile
Home
Work
Other
Address
Home
Work
Other
Country
Country
Street address
Apt/unit/box (optional)
City
State
Postal code
Birthdate
Date
Gender
Select…
Male
Female
Will you have a co-leader? If so, list them here.
Are you willing to host in your home?
Yes
No
What day(s) of the week are you able to have your group meet?
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
What time will your group start and end?
Who is your group for? (singles, couples, parents of teens, ect.)
Are you willing to host children at your group?
Yes
No
Anything else you would like us to know? Do you have any questions for us?
Submit
A copy of your responses will be sent to your email address.
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