Wesley Group Registration Form

 Please complete and return this form to the church office.

First Name:   ___________________    Last Name: ______________________

Street Address: ____________________  City: _________ State: __ Zip: _____

Email address: __________________________     Phone:  ________________

I am (Circle One):      Single        Engaged        Married        Widowed

I am (Circle One):      18-29        30’s         40’s        50’s         60’s         70+

Spouse’s or significant other’s name (If they will be participating):  _____________

Number of Children: ____     Ages of Children: ___________________________

I am (we are) able to meet (Circle all that apply):

  Sunday         Monday        Tuesday        Wednesday        Thursday        Friday        Saturday

Good time(s) for my group meeting to start is (Circle all that apply):  

                    Early Morning (6:00-9:00)            Morning (9:00-12:00)        Afternoon (12:00-5:00) 

                          Early Evening (5:00-7:00)              Evening (7:00-9:00)           Late Evening (9:00-12:00)

What is most exciting to you about joining a Wesley Group?

___  Meeting new people      ___  Furthering my Christian Journey     ___  Getting to know others  

___  I’m a new member and I want to make connections

___  Other: (Please explain)

Is there any additional information you would like for us to know?

 3077 Valleyview Drive     Toledo, Ohio 43615      419.531.4236

        Email:    Info@EpworthWesleyGroups.com

             All rights reserved.  Copyright 2004-2008  Epworth UMC Toledo Ohio