MIX Group Registration Form - The Mix Church

Become a MIX Group Leader by completing and submitting the form below to register your group for the Winter/Spring 2023 semester (02/19-04/29)!

Group Leader Name*
First Last
Group Leader Email*
Group Leader Cell Number
Group Co-Leader Name
First Last
(if applicable)
Group Co-Leader Email

(if applicable)
Group Co-Leader Cell Number
(if applicable)
Group Name*

Name your MIX Group
Group Type*
Sermon-based or Special Interest
Click Here for Topic Ideas & Resources for MIX Groups
Special Interest Group Description*
Special interest Group Description including any resources your group members will need to get
Target Audience*
Who can attend your group
Meeting Location*
In-person or Virtual
Request to meet at THE MIX?*
- No
- Yes - Baltimore Street Location
- Yes - Dunbar High School Location (Sundays at 12:30pm only)
In-Person Location*
Street Address Address Line 2 City State ZIP Code
Meeting Cadence*
Weekly, Bi-weekly, or Monthly
What day of the week would your Group meet?*
Meeting Time*

: Hours

Minutes

What time will your group begin?
Meeting Duration*
How long is your group time?
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Name
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