registration card

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REGISTRATION CARD

Today’s Date: ____________ PERSONAL INFORMATION Full Name: ______________________ Spouse’s Name: __________ Street Address: __________________________________________ City: ____________________________ Zip: _________________ Phone Number: _________________________________________ Email: _________________________________________________ Marital Status Single Single Parent Married Widowed

Your Age Group College 21-30 31-40 41-50 51-60 61+ Number of children: _________

Ages of children: _________

GROUP INFORMATION Which evenings are you available to participate in a vGroup? (Please select at least 2)

SUN

MON

TUE

WED

THUR

FRI

SAT

Have you completed the membership process at Vanguard? YES

NO

IN PROCESS

How long have you been attending Vanguard? < 1 MONTH < 3 MONTHS < 6 MONTHS

6+ MONTHS