| Date: | |
| Full Name | |
| Address | |
| City, State, Zip | |
| Home Phone | |
| Work Phone | |
| Cell Phone | |
| Contact Email | |
| Birthdate | |
| Gender |
|
| Marital Status |
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| If married, is your spouse in total agreement with you leading a small group? |
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| If no, please explain: | |
| When did you commit your life to Christ? | |
| Briefly describe your salvation experience: | |
| Are your faithful to the Biblical principle of tithing 10% of your income? |
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| Are you currently a member of a small group at CHC? |
|
| Who is your current small group leader? | |
| I would describe my quite time as: |
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| Are you faithful in attending weekly celebration services? |
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| If no, why not? | |
| Have you or your spouse ever been convicted of a felony? |
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| Do any current activities in your personal life conflict with any Biblical values or principles (i.e.alcohol, tobacco, drugs, gambling, pornography, etc.) |
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| Have you attended the Front Door Membership Classes? |
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| Are you a CHC member? |
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| Occupation | |
| Spouse's Occupation, if married | |
| Are you faithful in paying your bills? |
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| If no, please explain: | |
| Does your employer or occupation conflict with any Biblical values or convictions? |
|
| If yes, please explain | |