Ministry Intake Form
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Ministry Intake Entry
Added: 4/25/2024
GENERAL INFORMATION
First Name
First Name is required.
Last Name
Last Name is required.
Email
Email address is not valid
Email is required.
Phone
Phone is required.
Address
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
Birthday
Birthday is required.
Gender
Male
Female
Gender is required.
Number of Dependents
0
1
2
3
4
5
6
7+
Marital Status
Single
Married
Other
Divorced
Separated
Widowed
Marital Status is required.
Spouse's First Name
Spouse's Last Name
Spouse's Birthday
Spouse's Email
Email address is not valid
Spouses's Phone Number
SCHEDULING INFORMATION
Are you a member of ITOWN?
No
Yes
Are you a member of ITOWN? is required.
Is your spouse a member of ITOWN?
No
Yes
What campus do you attend?
Olson Farms
Bluffton
Mudsock
TV
Online
National TV
What campus do you attend? is required.
What days are you available to connect?
Tuesday
Wednesday
Thursday
Friday
What days are you available to connect? is required.
What times?
Morning
Afternoon
Early Evening
Any
What times? is required.
DISCUSSION DETAILS
Please select one or more topic items what you would like to discuss.
Students
Nursery/Preschool
ITOWN Kids
Youth
College
Family
Marriage
Parenting
Other
Financial
Planning
Assistance
Other
Personal
Emotional
Grief
Addiction
Other
For any Other boxes checked, please explain:
PASTORAL CARE INVOLVEMENT
Have you been in contact with a Pastor or Leader? If so, who?
Have you been in contact with a Pastor or Leader? If so, who? is required.
Please provide a brief overview of your current need, and how we can help:
Please provide a brief overview of your current need, and how we can help: is required.
CIRCLE / SMALL GROUP INVOLVEMENT
Have you ever participated in a Circle?
Currently
In the Past
Never
Have you ever participated in a Circle? is required.
Has your spouse?
Currently
In the Past
Never
Group Name(s) You Attended:
Group Name(s) Your Spouse Attended:
Group Name(s) Lead / Co-Lead:
Group Name(s) Spouse has Lead / Co-Lead:
GO TEAM SERVICE
Are you currently serving on a Go Team?
No
Yes
Are you currently serving on a Go Team? is required.
Is your spouse currently serving?
No
Yes
What weekend team(s) do you serve on?
Connect
Creative
Data Entry
Facilities
First Responder
Greeter
Grow Plan
Hospitality
Intercessory Prayer
ITOWN Cares
ITOWN Kids
ITOWN Youth
Kids Check-In
Nursery/Preschool
Parking
Production
Red Tent
Usher
White Tent
Worship Guide Prep
Worship
Black Tent
What weekend team(s) does your spouse serve on?
Connect
Creative
Data Entry
Facilities
First Responder
Greeter
Grow Plan
Hospitality
Intercessory Prayer
ITOWN Cares
ITOWN Kids
ITOWN Youth
Kids Check-In
Nursery/Preschool
Parking
Production
Red Tent
Usher
White Tent
Worship Guide Prep
Worship
Black Tent
What other teams do you serve on?
Events
Missions
Prayer Response
Prison Ministry
Circle Leader
Foster Friends
ITOWN Youth
What other team(s) does your spouse serve on?
Events
Missions
Prayer Response
Prison Ministry
Circle Leader
Foster Friends
ITOWN Youth
ADDITIONAL INFORMATION
Have you struggled with any of these in the past?
Abuse
Alcohol
Anxiety
Depression
Suicide
Other
Are you currently struggling with any of the following?
Abuse
Alcohol
Anxiety
Depression
Suicide
Other
Other:
Anything else you would like us to know?
Submit