Action Group Facilitators Information

First Name*

Last Name*

Email*

City of Group*

If a virtual group, please write "Virtual" in the box.

Cost per Month per Participant

Group Start Date*

Date of first group meeting.

All Meeting Dates*

Please list all scheduled meeting dates (click the "+" to add additional rows).

Meeting Location*

Participant Names and Contact Info*

Name	Email	Phone Number

Please list all participants and their contact information.

Are all covenants signed and returned*

If no, who are you still waiting on to sign their covenant??

Please list all participants who have yet to sign their covenant.

Any other details we should be aware of?

Guides Names and Contact Info*

Name	Email	Phone Number	Name of Business

Please list all participants and their contact information.

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Comments

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Action Group Facilitators