HSM Connect Form 2016-2017

Thank you for completing the High School Ministries Connect Form, we're excited to have you involved in HSM! Please complete this form to register for Home Group for the upcoming year. If you were a part of HG last year, you will need to reregister. If you have any questions, feel free to contact the HSM staff at hs@blackhawkchurch.org. 

Student/Parent Information:

*Student First Name:
*Student Last Name:
Student Email:
Student Cell Phone:
*Gender:
*Birthdate:
*What is your graduation year?:
*What school do you attend?:
*Address:
_________________________________________
*Parent 1: First Name:
*Parent 1: Last Name:
*Parent 1: Cell Phone:
Parent 1: Home Phone:
*Parent 1: Email:
Parent 2: First Name:
Parent 2: Last Name:
Parent 2: Cell Phone :
Parent 2: Home Phone:
Parent 2: Email:

Home Group Information:

Home Groups meet in 7 different location on Wednesday nights from 7-9 pm. Based on your geographic location, which Home Group will you attend? 
*Home Group location:
NOTE: While we strongly encourage students to attend the Home Group that fits this description, we realize there may be circumstances where a student wishes to attend elsewhere. If so, please choose the group your student wishes to attend:
Please list two friend requests (same gender):
Please list two leader requests (same gender):
*Did you attend Home Group previously?:
Which Home Group were a part of?:
Who were your small group leaders?:

BLACKHAWK CHURCH
9620 Brader Way
Middleton, WI 53562
608.828.4200


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