New Life Ministries: Survey - Small Group Registration

Submit your groups application and get national recognition in the New Life online directory.

	Group Information:
*1.	Question - Required - Group Name:
2.	Question - Not Required - Choose a Support Group Type:
3.	Question - Not Required - or Small Group Type:
*4.	Question - Required - Established Year:
*5.	Question - Required - Entry Type:
*6.	Question - Required - Gender Type:
*7.	Question - Required - Leader Type:
	*Groups not lead by a licensed counselor are required to fill out these fields below.
8.	Question - Not Required - Church Sponsor:
9.	Question - Not Required - Church Phone:
	Meeting Information:
10.	Question - Not Required - Fee Amount:
*11.	Question - Required - Day of the Week / Time:
12.	Question - Not Required - Address:
13.	Question - Not Required - City:
14.	Question - Not Required - State:
15.	Question - Not Required - Zip:
	Contact Information:
*16.	Question - Required - Contact Name:
*17.	Question - Required - Contact Phone:
*18.	Question - Required - Contact Email:
	Additional Notes or Comments:
*19.	Question - Required - Has the group leader ever participated in a New Life training event? Yes No
*20.	Question - Required - Is New Life material used in this group? Yes No
*21.	Question - Required - Is your group handicap-accessible? Yes No
22.	Question - Not Required - Comments: (Maximum response 255 chars, approx. 5 rows of text)
	Please note that there is a brief approval process before your support group will appear in the directory. Once your information is entered into the Group Directory we will contact the person noted.