Rock Sign-up Sheet For Perfectly Positioned Small Groups

First name: Last name:

Street:

City: State/Province : Zip/Postal code:

Home Phone: E-Mail:

Work Phone: Cell Phone:

Age: Marital Status:

Please select a small Group Leader from the list below:

Note: This is only a preference, as the first 10 people to select a leader can be a part of that group

Choose Your 1st Preference for a Small Group Leader

Write in your Choice for your 2nd & 3rd Preference for a Small Group Leader from the above list:

Time & Day of Week of Meeting: Wednesday 7:00 PM at The Rock of Roseville, 725 Vernon Street.

Sign-up For Perfectly Positioned Small Groups Ages High School Age & Up
Please provide us with the folllowing information by filling out the form below. Then hit the submit button when completed First name: Last name: Street: City: State/Province : Zip/Postal code: Home Phone: E-Mail: Work Phone: Cell Phone: Age: Marital Status: Please select a small Group Leader from the list below: Note: This is only a preference, as the first 10 people to select a leader can be a part of that group Choose Your 1st Preference for a Small Group Leader Write in your Choice for your 2nd & 3rd Preference for a Small Group Leader from the above list: Time & Day of Week of Meeting: Wednesday 7:00 PM at The Rock of Roseville, 725 Vernon Street.