Discipleship Group Interest Form

Phone number *

Preferred Method of Contact *

Text

Phone Call

Email

Preferred Day/Night to Meet *

Please check all that apply

Sunday

Monday

Tuesday

Wednesday

Thursday

Preferred Geographic Location of Discipleship Group *

Please check all that apply

Meet at the church

Glen Allen

Midlothian

Mechanicsville

Chesterfield

West End

Willow Lawn

Other

Is there any other information you would like us to know before contacting you?