Small Groups

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* 1. What is your name?

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* 2. Where are you from?

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* 3. What is your age group?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 4. Have you been a part of a small group before?

Yes

No

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* 5. Why do you want to join a small group?

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* 6. What time of day are you available?

Early

Mid Day

Late

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* 7. What is the best number to contact you?