Full Name Spouse's Name (if applicable) Email Phone Number What is the best way to reach you? Email Phone Address Street, City, State, ZIP Check the age group(s) that best represents you (and your spouse). 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-69 70 and older Do you have children? If yes, then please put their names and ages in the space provided below. Yes No Will you need to bring your children to Life Group meetings with you? Yes No Which days of the week are you able to meet? Any Day of the Week Sunday Monday Tuesday Wednesday Thursday Friday Saturday In the space below, please provide any additional information or requests that may help us to better place you in a Life Group.