Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Have you attended 101 and become a member of Grace Fellowship?

Yes

No

Attended 101, but not a member yet

Do you understand the LifeGroup leader qualifications and expectations, as listed on the web page? *

Yes

No, please reach out to me for clarification.