Corporate Worship & Small Group Participation Submission Form

LEAD Programs Only

Please fill out the following fields and click submit once per semester. Print out the confirmation page for your records.

Student Name
Telephone
Email Address
Reporting Period
Year

Corporate Worship

Submitting this form indicates your weekly attendance, with rare exceptions, at a corporate worship service at the church listed below.

Name of Church
Address
City/State/Zip
Telephone

Small Group

Submitting this form indicates your weekly, with rare exceptions, attendance in the small group listed below.

Name of Group
Name of Church it is affiliated with (if any)
Group Leader
Telephone
security code
Enter Security Code:

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