New Connect Group Sign Up

NEW CONNECT GROUP

Sign Up Form

Leaders Information

* Indicates required field

Leader's Name(s) *

First

Last

Database Password (8 characters, 1 letter, 1 number) *

Email Address *

Mobile *

This password is for access to the database where you will manage your group & submit reports

Group Details

Assistant Leader's Name(s) *

First

Last

Host's Name(s) *

First

Last

Address *

Suburb *

Post Code *

What time will the group meet? *

Group Members

Name 1 *

First

Last

Name 2 *

First

Last

Name 3 *

First

Last

Name 5 *

First

Last

Name 4 *

First

Last

Name 6 *

First

Last

Name 7 *

First

Last

Name 8 *

First

Last

Name 9 *

First

Last

Name 10 *

First

Last

Other information or questions for Ps Fiona *

Submit