If you would like to be a part of a Small Group, or perhaps start one, simply fill out this form and someone will contact you!

   First Name      Last Name
Home Phone      Cell Phone 
           Email  
       Address  
             City      State     Zip Code

Best way to reach me:  Home Phone Cell Phone Email

I am interested in the following type of group:

Men's Group  Women's Group  Blended Family Group  Couple's Group

Single's Group  Young Adult's (18-29) Group  Mixed Group (Singles/Couples)

We have groups that meet all over Dayton.  Please help us narrow down your search by providing the following information:

These days & times work best for me:

I definitely cannot meet these days & times:

I am interested in learning about Small Group Leadership and possibly leading a group:
Yes    No

Specific questions can be answered by Christian Life Center - just contact us.