START A GROUP New Small Group / Affinity Group Form Name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Address* Street Address City ZIP / Postal Code Home Phone*Alternate PhoneEmail* Contact Method*Home PhoneAlternate PhoneEmailHow long have you attended KPC?*Are you a member?*YesNoHave you lead a small group before?YesNoPreferred day/night*MondayTuesdayWednesdayThursdayFridaySaturdaySundayWhat is the focus of the group?check all that applyAge/Stage Based Couples Mixed Adult Men's Women's Singles Families Interest Based Sports Computers Third Choice Seekers Bikers Mature Christians Other** Task Based Food Pantry Greeters Vocal Teams Mission Teams Other** Need Based Recovery Groups Grief Support Post Abortion Other** **If "Other" please specify:What resources would you use?Check all that apply Study guides Books Videos Title & Author:Study guidesTitle & Author:BooksTitle & Author:VideosWhat is the lifespan for your group?Less than 3 months3 months to 1 year1 year to 2 yearsMore than 2 yearsDo you have a co-leader or an apprentice leader for your group?Co-LeaderApprentice LeaderBothCo-Leader Name First Last Co-Leader PhoneCo-Leader Email Apprentice Leader Name First Last Apprentice Leader PhoneApprentice Leader Email Are all leader(s) willing to attend our leadership development meetings (2 or 3 x per year)?YesNoComments:Are you open to new people joining your group?Yes - for entire lifespan of groupYes - up to a certain weekYes - but depends on nature of taskUntil which week may people join?12345678910Which of our KPC goals areas will likely be evidenced in your group? (check all that apply) Spiritual Formation - scripture, prayer, simplicity, obedience Opportunities to Serve - with our time, gifts, talents and resources Godly Relationships - connect, build trust, help and encourage others Reaching Outward - empowering one another to connect people to Jesus What support might you need from Kortright? (check all that apply) Advertising Meeting space Childcare Other Other:Will you submit a 6 month progress report on behalf of your group?YesNoComments:Do you envision your group multiplying (birthing) in 2 to 3 years?YesNoComments:CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.