Women's Discipleship Interest Form 2018-2019

Please complete the form below to help us prayerfully connect you with a leader, group, location, and meeting time that is best for you.

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

PARTICIPANT INFORMATION
*Age:
*Are you married?:
*Do you have children?:
Childrens ages:
Children's school(s):
Do you need childcare during discipleship?:
Are you be interested in a biweekly Working Moms group (if your children are under age 15)? :

DISCIPLESHIP INFORMATION
*Are you a member of Perimeter Church?:
*How many years have you been a Christian?:
*How many years have you been at Perimeter Church?:
*Have you participated in discipleship previously?:
*What are you looking for in a discipleship group?:
What days of the week are you available?
What times of day are you available?
If you have a group in mind, enter leader's name.:
Additional comments or questions.: