Are you interested in joining a small group?

  Name:

  Address:

  City:   State:   Zip:

  Phone:

  Email:

  Age:

  Marital Status


When are you available to meet?

  Please indicate your first and second choice of day and time.

  First choice:

  Second choice:


Where is the best location for you to meet? (Lake Forest, Christ Church, Libertyville, etc.)

  First choice:

  Second choice:


What type of group?

  


Additional Information:

  




Mary Funk
847-234-1001 x159
Christ Church Lake Forest
100 N Waukegan Rd
Lake Forest, IL 60045