Mentorship / Discipleship Application
Please fill out this form as soon as possible, and click submit.
Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
About Me
Please write a short paragraph about your faith journey.
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What is your educational background? (degree(s), fields of study, etc.)
*
What year were you born? (this will help in the pairing process)
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Do you know what your spiritual gifts are? If so, please describe.
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Why do you want to be mentored at this time?
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What is your preference for the age of your mentor?
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Please select all that apply.
Around my age
Somewhat older than me
Significantly older than me
No preference
Have you ever been discipled or mentored before?
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Please select one option.
Yes
No
If you have been mentored before, please describe the context (professional, spiritual, etc.) and what your experience was like.
What are your goals for being mentored? (i.e. what outcomes would you like to see in your life?)
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Being mentored will take time and work. Are you willing to faithfully attend mentoring meetings and work on any assignments given?
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Please select one option.
Yes
No
Not sure
For what length of time would you like to engage in a discipleship /mentoring relationship (meeting approximately twice per month)? Check all that apply.
*
Please select all that apply.
4 months
6 months
9 months
12 months
Are you interested in being mentored one-on-one, being mentored in a group of 2-4, or are you open to either option?
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Please select all that apply.
1:1
Group of 2 - 4
Either option
What areas in your life do you most want to grow in? (check all that apply)
*
Please select all that apply.
Healing of Soul
Relationships
Outreach
Prayer
Worship
Word
Understanding Strengths
Finances or Career
Other
How do you spend your free time? (hobbies, interests, etc.)
*
When would you prefer to start the discipleship/mentorship process?
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Please select one option.
Now
In a month or two
In 3 to 6 months
Select Option
Now
In a month or two
In 3 to 6 months
Do you have any questions about our discipleship/mentoring program?
*
Submit
Description
Please fill out this form as soon as possible, and click submit.
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