Participant Application

Group Life Participant Application

Personal Info

Name

Date of Birth

Marital Status

Single
Engaged
Married
Separated
Divorced
Remarried
Widowed

Does your spouse attend

Yes
No

Spouse's Name

Spouse's Date of Birth

Contact Info

Street Address

City

ZIP

Home Phone

Phone

This is my...

Home Phone
Cell Phone
Work Phone

Email

Family Info

Do you have children?

No
Yes, at least one in the nest
Yes, but we're empty-nesters

If yes, what are their names and ages?

What are some of your family's interests, activities, and hobbies?

Spiritual Info

What description best fits your spiritual status?

I'm still seeking answers before I become a Christian
I've become a Christian quite recently
I've been a Christian for a while
I've just recommitted myself to Christ

How long have you attended SCC?

How long have you lived in the area?

Have you been in a small group at SCC in the past?

Yes
No

If yes, which group?

Have you been in a small group at any other church?

Yes
No

If yes, which church?

City

Expectations

What expectations do you have of Group Life?