Community Group Connect Form

Your name *

Last name

Email address *

Phone Number

Phone type

MobileHomeWorkOther

Address

HomeWorkOther

Country

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Preferred Method of Contact

Select…PhoneEmail

How Long Have You Been Attending Village Church? *

Select…1-6 Months7-12 MonthsMore than 12 MonthsI Do Not Attend

Age Demographic

Select…Under 1818-2526-3536-4546-55Over 55

Childcare Needed?

Preferred Day of the Week

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

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