L.I.F.E. Group Interest Form

We're excited to reach out to you!

Your name *

Last name

Email address *

Phone number

Phone type

MobileHomeWorkOther

Birthdate

Address

HomeWorkOther

Country

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Gender

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Occupation

Marital status

Select…SingleMarriedWidowed

Is this your first time to join a LIFE group?

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Church Membership Status

Select…Active memberMember of another churchMember but due to circumstances, can't attend servicesI've been out of church for a while and want to get connected with believers

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