The Ridge - Prairie Ridge Church

First Name

Last Name

Email

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Birthdate

Marital Status

How long have you attended the Ridge?

Please describe your current life stage

I currently live

Are you seeing a professional therapist or counselor?

Is it important to you that your fellow triad members be similar in age to you?

If you know one or two other women you've talked with about the triad program and would like to have in your triad, please indicate their names below. If you would like to be placed with other women by our program team, leave this area blank.

Please explain your current relationship with Jesus

What is your greatest goal for participating in this program?

Triad Program Form

Please fill out the form below and we will be in touch shortly.