First Name
Preferred Name
Last Name
Gender
Male
Female
Date of Birth
Marital Status
Single
Engaged
Married
Partner
Widowed
Divorced
Separated
Anniversary
Email Address
Home Phone
Mobile Number
Home Address
Home Address Line 2
Home City
Home Province
Home Postal Code
In House Media Permissions
Yes, you may take my photo/video
No, you may NOT take my photo/video
How did you find out about Impact Church?
Friend/Family
Advertisement
Website
SocialMedia
Outreach
Other
School Grade
-- None --
Pre-School
Jr. Kindergarten
Sr. Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Post-Secondary
Have you attended a Newcomer's Connection? (Previously "Open House")
Yes
No
Have you completed Launch? (The first step Small Group in our Growth Track)
Yes
No
Would like more info
Have you been water baptized?
Yes
No
Would like more info
Have you completed Activate?
Yes
No
Would like more info
Have you attended an Encounter Weekend?
Yes
No
Would like more info
Are you a church member at Impact?
Yes
No
Would like more info
Are you on a Sunday morning serve team at Impact?
Yes
No
Would like more info
Are you interested in leading a Small Group?
Yes
No
Would like more info
Are you willing to host a Family Feast? (Potluck lunch with 10-25 people in your home after church on a Sunday)
Yes
No
Would like more info
Are you part of, or would you like to join the Meal Train? (group of people who bring meals to those in our church going through difficult times)
Yes
No
Would like more info
Are you willing to offer rides to church or church events?
Yes
No
Would like more info
Are you available for midweek volunteer opportunities?
Yes
No
Sometimes
Would like more info
How often do you attend Impact?
3-4 times a month
1-2 times a month
once a month
less than once a month
Do you own a van, truck or trailer?
Yes
No
Do you have a Safe Food Handling Certificate?
Yes
No
Do you speak a language other than english?
Yes
No
If yes, what language(s)?
Are there any sermon series topics you'd be interested in hearing us address?
These are areas of skill, training or experience I have to offer when needed or called upon.
Admin
Construction
Repairs
Fundraising
Decorating for events
Painting
Stage Design
Auto-mechanic
Landscaping
Photography
Videography
Video Editing
Social Media
Sound tech
Computer trouble shooting/IT
Making gift baskets
Janitorial/Cleaning
Meals/Cooking/Baking
Prayer
Evangelism
Teaching
Hospital/Home Visitation
Youth Ministries
Children's Ministries
Women's Ministries
Men's Ministries
Young Adult Ministries
Missions
Other Skills/Expertise
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