Disciple User Registration Form

BECOME A DISCIPLE

What Church do you go to?

What is your Name

What is your Address

What is your Phone Number

What is your Email

Are you a Male or Female

What is your age

Which statement best describes you

You will be connected first with someone inside your church. If there is no one inside the church volunteering, would you mind if we look outside of your church?

This will require one hour a week to meet and talk with your mentor. What time of day works best for you.

BECOME A DISCIPLE

TOTAL CAMPERS SPONSORED: 10

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