| First Name | | |
| Last Name | | |
| Email | | |
| Group Attendees: James Luka, Lynda Luka, Tom Dahl, Susan Dahl, Kaye, Holliman, Sharon Shoup, Dan Williams: if any member has been absent twice or more this month, please list name | | |
| |
| Small Group Name | | |
| Month Ending | | |
| Outreach Ministry Event | | |
| Type of Outreach | | |
| Fun Event | | |
| Type of Fun Event | | |
| What growth do you see taking place among the people in your group? | | |
| What challenges are you facing with your group? | | |
| Potential small group leader from group? | | |
| New Group Members (those not listed above), Phone, Email | | |
| Do you want the the leader of the small group ministry to contact you? | | |
ineyard Community Church®