First Name (required) Life Group Name Name of Organization/Ministry where you Served (if applicable) Service Opportunity (What did you do?) Length of Time Served (in hours) Number of People Served Last Name (required) I serve my group as our: Facilitator/LeaderCoordinatorMission Liaison Date Served (required) How many life group members participated? Was the Gospel shared? YesNo Number of Salvations (if applicable) Additional Comments