Feedback Form

Name:(Required)

First Last

Grade:(Required)

Small Group Leader(s):

Feedback 1-5: (circle 1)

Favorite part about Focus:

Least favorite part about Focus:

I have decided...

To give my life to Jesus for the first time

To follow Jesus in the next step of baptism

To plug into a Community Group

To learn more about a relationship with Jesus

Parent Name:

Phone Number:(Required)