Connect Group Consultant - 2023

Fill out this form if you would like to join a Connect Group. You will be contacted by a member of our team so that we can help place you in a group that works for you.

Name

*

Email

*

Phone

*

Address

*

Gender

*

Please select all that apply.

Male Female

Birthdate

*

What Campus do you attend?

*

Please select one option.

Doral Dadeland Online

What type of group are you looking for?

*

Please select one option.

Couple's Men's Women's Young Adults (18-29) Co-Ed Adults

What are your preferred days?

*

Please select all that apply.

Monday Tuesday Wednesday Thursday Friday Saturday

What are you looking for in a connect group?

*

Description

Fill out this form if you would like to join a Connect Group. You will be contacted by a member of our team so that we can help place you in a group that works for you.

Please Fix the Following

Close