Group Leader Entry

We are so excited that you are interested in leading a small group! Please complete the form below. Once your group is approved, the my.Heartland portal will allow you to add your co-leader(s) to your roster.

Group Leader Information

First Name

Last Name

Mobile Number

Group Meeting Information

Group Name

Group Description

Curriculum Title & Author

What is your target audience?

Group Type(s)

Ages

18-22 20’s 30’s 40’s 50’s 60’s All Ages

Will Group meet In Person or Virtual?

Group Location

Meeting Address

Day of Week

Time of Day

Show in Directory

Child Care Provided

Max Participants (Including Leaders and Co-Leaders)

Submit