Men's Discipleship Interest 2017-2018

Fill in the below to indicate your interest in joining a men's discipleship group. We look forward to helping you connect with the right group.

*Address Line 1
Address Line 2
*City
*State/Province/Region
*Zip/Postal Code

PERSONAL INFORMATION
*Cell Phone
*Age
*Are you married?:
*Do you have children?:
If yes, please specify their ages:
*Are you a member of Perimeter Church?:
*How many years have you been a Christian?:
*How many years have you been at Perimeter Church?:

DISCIPLESHIP INFORMATION
*Have you participated in a discipleship group previously?:
*What are you looking for in a discipleship group?:
What are the best days of the week to be in a group with least hindrance?
If you have a group in mind, enter leader's name:
Additional comments: