First UU Covenant Group
Facilitator Sign-up Form

 

artwork by Sandy Aska

Personal Information

 

Name [required]:

 

Address (City, State, Zip):

 

Phone [required]:

 

Cell phone:

 

Email [required]:

 

Preferred time to be contacted:

 

Other Information (check all that apply)

 

I can offer my home as an occasional meeting location

 

I need child/adult care

 

I need a sign language (ASL) interpreter

 

I have other ADA needs (Please describe below)

 

I have transportation needs (Please describe below)

 

I have other requirements to participate (Please describe below)

Anything else we need to know? Special needs, instructions or information? (fill in below)
List the name of any individual you need to have in your covenant group for a specific reason (such as your reliance on them for transportation). That person must also be registered.
Please include their name and the reason you need them.

 
 

Using both sections below, please indicate your availability. Mark as many as are possible for you.

(Meetings 1st and 3rd weeks of the month)

  Monday 7 PM to 9 PM
  Tuesday 1 PM to 3 PM
    7 PM to 9 PM
  Wednesday 1 PM to 3 PM
    7 PM to 9 PM
  Thursday 9 AM to 11 AM
    1 PM to 3 PM
    7 PM to 9 PM
  Friday 9 AM to 11 AM
  Saturday 10 AM to Noon
  Sunday 6 PM to 8 PM

(Meetings 2nd and 4th weeks of the month)

  Monday 7 PM to 9 PM
  Tuesday 1 PM to 3 PM
    7 PM to 9 PM
  Wednesday 1 PM to 3 PM
    7 PM to 9 PM
  Thursday 9 AM to 11 AM
    1 PM to 3 PM
    7 PM to 9 PM
  Friday 9 AM to 11 AM
  Saturday 10 AM to Noon
  Sunday 6 PM to 8 PM

How to Sign Up to be a Facilitator
Fill out this online form and click the SUBMIT button at the bottom of the form. 

Thank you for your interest.
The Covenant Group Steering Team

Direct questions to:
First UU Office (phone: 614-267-4946)

or email _uucovenantgroups@firstuucolumbus.org  
( Note: remove initial underscore from email address before sending email. )  

 

revised 2008-08-13