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Name: |
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Email Address: |
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Major(s): |
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Cell Phone Number: |
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Room Extension Number: |
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Campus Mailbox Number: |
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Housing (Dorm & Room Number): |
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Year: |
First Year
Sophomore
Junior
Senior
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What type of group would you like to lead? (check all that apply) |
All first-years
All sophomores
All juniors
All seniors
Mixed class levels
Whatever's needed
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What will your campus involvements be next year, including work, clubs, activities, special research projects, etc.? |
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Why are you interested in becoming a Koinonia small group leader? |
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Briefly share your testimony and/or how God is working in your life. |
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Please select a group leadership option: |
I would like to lead the group by myself.
I would like to co-lead the group with another person.
I would like to have various members take turns leading.
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Please desired co-leaders (if any). |
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If you wish to have multiple leaders in your group, are you willing to be the "contact person" or "head leader" for your group? |
Yes
No
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Group type: (check all that may apply) |
Bible study
Book study
Service group
Prayer group
Special interest group/other
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If you selected "special interest", please explain below. |
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Please select a mentorship option. |
We already have a mentor for our group.
We would like to have a mentor assigned to our group.
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If you already have a mentor, please list his/her name, email address and phone number below. (Male groups must have male mentors, female groups must have female mentors, and all mentors must be older than college students.) If you would like to have a mentor assigned to your group, please list all preferences for a mentor (if any) below. |
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Additional comments. |
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