Name of Event: Perimeter Church Membership Profile
Contact Information: Nicole Godbey at
678-405-2241

First Name *
Last Name *
Date of Birth * (mm/dd/yyyy)
Address *
City *
State *
Zip *
Subdivision
High School (attend or zone you live in) *
Home Phone Number *
Work Phone Number
Cell Phone Number
Email Address *
Gender *
Ethnicity
Marital Status *
Spouse's Name
Anniversary Date (mm/dd/yyyy)

EMPLOYMENT INFORMATION
Employer
Occupation

CHILDREN'S INFORMATION
Child's Name
Child's Date of Birth (mm/dd/yyyy)

Child's Name
Child's Date of Birth (mm/dd/yyyy)

Child's Name
Child's Date of Birth (mm/dd/yyyy)

Child's Name
Child's Date of Birth (mm/dd/yyyy)

Child's Name
Child's Date of Birth (mm/dd/yyyy)

JOINING PERIMETER CHURCH
How did you hear about Perimeter?
Name of family/friend, if applicable
I am joining Perimeter Church by:
Transfer Church Name (required if joining by letter of transfer)
Transfer Church Address (required if joining by letter of transfer)
Reason for Transfer

BAPTISM
Church where baptized
Date Baptized (mm/dd/yyyy)
If you have never been baptized, this is a MUST prior to becoming a member. Elders will provide more information during your appointment.

TESTIMONY
Please write a brief account of your conversion to Jesus Christ (your testimony). Briefly explain how and when God graciously brought you to Himself. *
If you were to die today, what reason would you give God for allowing you into heaven? *

MINISTRY INVOLVEMENT
Currently serving in the following ministry area(s)
Congregational Involvement (please check if you are CURRENTLY involved in any of the following) Discipleship (Women's)
Discipleship (Men's)
Encouragers: 30s/40s
Gathering: college–early 30s
Harvesters: 50s
Marriage Hour
Newlyweds
Victors: 60+
Cross Connection: Singles 35+
Name of Group Leader
My skills and interests (check all that apply) Audio/Visual
Business Administration
Communication
Counseling
Discipleship
Evangelizing
Hospitality
Information Technology
Leading a Team
Marketing/Sales
Office Work
Planning/Organizing
Praying
Project Management
Strategic Planning
Teaching
Web Design
Working with my hands/Building
Worship Performance
Ministries I'd Like to be Involved With (check all that apply)
Adults Marriage Ministry
Men's Ministry
Women's Ministry
Young Adults (Gathering)
Stephen's Ministry (Lay Counseling)
Guest Services (greeting/ushering)
Newcomers
Support/Counseling/Care
Harvesters

Children/Youth Kids Town (Infant-6th grade)
Student Ministry (Jr/Sr High)
Bricks (Jr/Sr High)
Mentoring To Fatherless And Motherless Children
Special Needs Youth
Academy of the Arts
Camp and Sports Outreach

Outreach Church Planting
Community Outreach
Global Outreach
Kingdom Investments

Events/Services Audio/Visual Production
Communications (Writing, Graphics)
Weekend Worship Services

Church Operations Accounting
Bookstore
Membership
I wish to serve in the following way
Classes I may wish to take Essentials of Faith
Intentional Living - LINK

Before you submit your form, please print it for your records. Thank you.