The Highland Vineyard

About You

Name (required) 

Address (required)  

City   State   Zip  

Neighborhood  

Phone Number   Email (required)  

How long have you been attending the Highland Vineyard? 

Age Group College Age 20s 30s 40s 50s 60s 70 or better

Small Group Preferences

I’d like to join a group as:  an individual as a couple (with my significant other)

I’m interested in:  a single-gender group a mixed-gender group.

I’d prefer:  a weekly group a biweekly group (every other week)

It’s better for me to meet on: weekdays weekends

It would work best in my schedule to find a daytime group an evening group

Other Needs

 I need to find a Small Group that is ‘Kid Friendly’ (babysitting available)
 I’d like to get involved in a group based on the 12-step recovery process