Covenant Group Application
Response Form                                        Date: _________
Name:_______________________________________________________________________________________________
Address: _____________________________________________________________________________________________
Phone: __________________________________________Email: ______________________________________________
Years in Fellowship: __________

□    I would prefer to join an ongoing Covenant Group!
I am available these evenings:  Mon___   Tue___   Wed ___   Thur___   Sat___   Sun___    
I am available these days: Sat___   Sun__
□    I would prefer a  4 month short term group  (6:30-8:30 pm Wednesdays; Jan. 28 Feb. 25, Mar. 31, and Apr. 28)
This is what I hope to experience with a Covenant group:_________________________________________________

These are discussion topics I’m interested :_______________________________________________________________

□    I am interested in Covenant Groups but I have the following concerns or questions:_______________________________________________________________________________________


Please return this form to our minister, Rev. Dottie Mathews.  Thank you!