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HSM Connect Form 2018-2019
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:
Male
Female
Other
*
Birthdate:
*
What is your graduation year?:
-- Select --
2019
2020
2021
2022
*
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:
Middleton East - 3719 Spring Hill Dr, Middleton
Middleton West -3229 Mound View Rd, Verona
Verona - 3717 Ice Age Dr, Madison
Waunakee - 1002 Warrior Crt, Waunakee
West Madison - 1217 Gilbert Rd, Madison
Mount Horeb - 312 Tvedt Dr, Mount Horeb
Fitchburg - 5887 Tree Line Dr, Fitchburg
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?:
Yes
No
Which Home Group were a part of?:
Who were your small group leaders?:
Submit Form