Pastoral Care Form
Name
Age
Goes By Name
Address
Phone
Email
Gender Male Female
Marital Status Single
Married
Separated
Divorced
Widowed
Meeting Preference Alone w/Spouse
How long have you attended Christian City Church? 0-3 months
4-6 months
6 months - 1 year
1 year +
2 years +
Do not currently attend Christian City Church
Attend a Connect Group? Yes No
What team(s) are you involved with at Christian City Church? 1st Impressions
Kidz Church
Worship & Creative Arts
Resource Table
Events
Detonate
Connect
Volunteer Central
Other
Team Leader's Name
Nature of Meeting Request