Wufoo

CLC Group Member Registration

Congratulations on accepting to be a part of the CLC Adventure!

Name * First Last
Mailing Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone * ### - ### - ####
Mobile Phone ### - ### - ####
Business Phone ### - ### - ####
Preferred Email *
2nd Email
Birth Date MM / DD / YYYY
Church Name *
Group Number
(ie: 396n) *

You should have received this number from your facilitator.
Co-Facilitator *
City Leader Location: *
Have you been in a previous CLC group? *
yes No
Over-night Kick-off Date * MM / DD / YYYY
Spouse's First Name
Company Name
Title
Preferred Method of Contact: *
E-Mail Cell Phone Home Phone "Snail Mail"
By Completing this form and sending it, you have agreed that after prayer and counsel with your spouse (if applies) , you feel led by God to complete the two-year equipping program and seek to lead for God's glory at home, community, and in your business. *
I agree
Once you check the box & "submit" this form you will be directed to a Book Ordering page. On this page you will need to enter the 3 codes given to you by your co-facilitator to order your study materials. Thank You!
Do Not Fill This Out