Johnson County Circle Leader Interest Form
Please complete this form for consideration to become a Circle Leader. This helps us know if our program will be a good fit for you and your goals.  We are not looking for perfection in your answers, just looking to get to know you better.  Feel free to share as much or as little as you are comfortable with. We will reach out after we review your answers. We are excited to get to know you!

Circle Leaders are individuals or families working toward economic stability. They are on a journey to have the resources, relationships, and purpose to set personal goals to move ahead. Our program is meant to form intentional friendships with volunteers called Circle Allies who will support the Circle Leaders toward their goals. Our meetings each week include a complimentary meal for you and any children attending with you.
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Email *
Name *
Date of Birth *
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Phone *
Preferred method of contact *
Address *
The Circles program begins with a twelve-week training to ensure that you have everything you need to be successful. We meet on Wednesdays from 6-8 p.m. in Franklin.                                                                      Are you able to attend every week for 12 weeks? *
If "no" please explain here.
After the 12-week training, we continue our Wednesday night meetings for 18 months. These meetings are with allies who support you in reaching goals.                                                                                        Are you able to attend these for 18 months after the 12-week training? *
If "no" please explain.
What is your current housing situation? *
Please describe any concerns you may have with your current housing situation (if any).
Describe your life now in as much detail as you are comfortable sharing.
If you had a magic wand, what would you change about your life in the next 2 years?
What are you good at? (Talents, Skills, Gifts)
What are some things you'd like to learn to help improve your life?
What do you hope to accomplish by participating in Circles?
For the duration of Circles, beginning with Training, the children and grandchildren of those participating are invited to attend the Children and Youth Track. Background-screened adults provide quality childcare (if we are able to meet in person) and educational activities for ages 0-18. These activities focus on similar concepts that the adults explore throughout training and into the Circles Initiative.                                                                                                  Do you have children or grandchildren that you would like to bring with you to Circles to participate in the Children and Youth Track? Please list ages and grades here.
Please list any question, comments, or concerns you may have about joining the program here.
How did you hear about us?
We will be in touch soon!
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