D-Group Sign-Up
Name:
Address:
City:
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Zip:
Phone:
Cell:
E-mail:
Gender Male Female
School:

School Year:

School Activities:

Hobbies/Interests:

Name of your previous sm. group leader:

Name of one friend you really want to be in a small goup with:

If possible, do you wish to stay with the same Small Group Leader?
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Note: Name, E-mail, and Phone Number are required fields.


Contact:

Jason Wetherholt
Family Life Minister

Jenni Kascel
Administrative Assistant

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Windsor Road Christian Church | 2501 W. Windsor Road | Champaign, IL 61822
p. 217.359.2122 | f. 217.359.7623 | © 2005 Windsor Road Christian Church