Grapevine Small Groups
Please fill this survey out completely and honestly. Your answers will only be seen by Anthony, Xavier, and limited key individuals necessary to succeed in this project.

NOTE: This survey is private and confidential. Your personal information will not be shared publicly, and will be safeguarded to the greatest possible degree.  
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Full Name *
Age *
In which city do you currently live? *
How long have you been involved with Grapevine? *
How willing/interested might you be in committing to a Small Group for a semi-long trial period (a few months, meeting once per month), based on the following description: *
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Not Interested
Highly Interested
What would you hope to gain from Grapevine and nurturing your faith via a Small Group commitment? *
Who are a few people you would be happy to be in a small group with? 

(Reminder that they will be split by male/female.)

(This can help us put you in touch in the future.)
How can we contact you? (Please provide and email and/or phone number.) *
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