Adopt Widow/Elderly

Adopt A Widow or Elderly Couple

Name of LifeGroup Leader(s)

First Name

Last Name

Phone

(xxx) xxx-xxxx

Address where LifeGroup is held

Address Line 1

Address Line 2

City

State

ZIP Code

Number of people/couples involved in the LifeGroup

Area of town where most of the group prefers to serve

Day of the week you would like to serve

How often are you open to serve?

(e.g. weekly, once a month, etc.)