- CHURCH NAME HERE -

FIRST TIMER’S INFORMATION FORM

Dear Friend, we are glad to have you here in church today. Kindly provide us with the following
information so we can easily get back to you.

SURNAME: __________________________FIRST NAME: ____________________________

OCCUPATION: _____________________________ GENDER: Male Female
MARITAL STATUS: Married Divorced Single Parent Single
ADDRESS: __________________________________________________________________
___________________________________________________________________________
FIRST PHONE NUMBER: _______________________________________________________
SECOND PHONE NUMBER: _____________________________________________________

YOU ARE INVITED BY: __________________________ TELEPHONE: ___________________

DO YOU LEAVE FULLY IN THIS CITY/TOWN? Yes No Partially
CAN WE VISIT YOU? Yes No
WHEN DO YOU WANT US TO CALL YOU? ________________________________________
WHAT DO YOU ENJOY MOST IN CHURCH TODAY? _________________________________
___________________________________________________________________________
WILL YOU LIKE TO MAKE HERE YOUR CHURCH? Yes No
PRAYER REQUEST: ___________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

FOR OFFICE USE ONLY:

ATTENDED TO BY: ___________________________________________________________
ASSIGNED TO THE CHURCH MEMBERSHIP OFFICER: Yes No
NAME OF CHURCH MEMBERSHIP OFFICER: _______________________________________
PHONE NUMBER: ____________________________________________________________
ASSIGNED TO FELLOWSHIP GROUP: Yes No
NAME OF FELLOWSHIP GROUP: ________________________________________________
FELLOWSHIP GROUP LEADER’S NAME: __________________________________________
PHONE NUMBER: ___________________________________________________________
ASSIGNED TO THE FOLLOW-UP TEAM LEADER: Yes No
FOLLOW-UP TEAM LEADER’S NAME: __________________________________________
PHONE NUMBER: ___________________________________________________________
INFORMATION ON THIS INFORM WAS DULY GIVEN TO THE THREE LEADERS ABOVE FOR
FOLLOW-UP: Yes No TODAY’S DATE: ________________________________