Name:                
Date:                   

Address:              
City:                       
State:                    
Zip:                        

Home Phone:     
Work Phone:       
Mobile Phone:      
E-mail Address: 
Best time to call:  

Birth Date:           
Sex:                       Male             Female

Marital Status:     Married            Single

Anniversary

Spouse's Name:      Birth Date:

Children's Names: Birth Date: 
                                                         
                                                         
                                                         

Background

Occupation:              
Company:               
How Long?             

If military what is your PRD/EAOS?    

Education/Training Completed:
High School   Trade School   Some College   College   Graduate School
Degree In:     Specialized Training: 


Spiritual Journey

I am a seeker (examining the claims of the Christian Faith.)
I am a new Christian (having recently made a decision to follow Christ.)
                 How long? 
I am a Christian.
                 How long? 
I have been baptized in water.
                        When? 
I have been baptized in the Spirit according to Acts 2:4.
                        When? 

How did you come to know Christ personally?


How do you further your relationship with Christ?


Passion to do for God:


What is your religious background and/or upbringing?


If you did attend a church, what activities were you involved in?


What church were you most recently part of?
Name:   
City:        
State:     

Why did you leave  your former church?


Who could we speak with there?
     Contact Information?

What do you hope will happen in your life as a result of becoming part of Seaport Community Church?


How much time do you have to give to volunteering each week?


Who do you know as an acquaintance, friend or relative at this church?


I have attended for:

Have you at this point identified your spiritual gift(s)?  yes   no 
If you have, please list them:


Do you prefer working in a group setting?         Or, by yourself?

Do you work better with a set list of things to do?                                      
Explain:


Or do you work better being able to decide on your own?    
Explain:
            

OPTIONAL QUESTIONS

How do you like to spend vacations?

What family activities do you enjoy?

How do you use free time?

What books and magazines do you read?

What organizations and clubs are you a part of?

Do you have a future goal you are currently working on? If yes, please briefly explain.

What event, besides becoming a Christian, has impacted your life the most?


How would you characterize your marriage?
Wonderful  Growing  Stagnant  Struggling  Needs Immediate Help

What is your greatest joy?

What is your greatest hassle?


Are you struggling with spiritual, emotional or physical issues?     Yes     No
If so, what?



Thanks for taking the time to complete this form. We will be in contact with you very soon to discuss how we can better help you.



Seaport Community Church
28 Great Brook Road, Groton, CT  06340
860-448-6224  FAX 860-448-6227