First Name

Last Name

Mobile Number

Email Address

Street Name and Number

Suburb

Postcode

Age Group

Please select your preferred Life Group category/s from the drop-down list FamilyAdultsYoung AdultsStudentsYouthWomenMenSri LankanSpecial Interest

Please let us know your preferred days of the week Select all that apply

Are you connected to a service/ location?

Notes

Tip: Please share any information that will help us connect you to the best suited Life Group eg "I've recently arrived in Australia ...", "I work irregular hours ..." etc