Page 20 | theREACHcentre Ottawa

Name (Required)

Email Address (Required)

Your Address (Required)

Your Phone Number

Birthday (Required)

Gender: (Required)

Female

Male

Ethnicity:

Black

White

Hispanic

Asian

Other

Prefer not to say

Language Spoken:

English

French

Spanish

African Dialect

Creole

Other

Marital Status:

Single

Married

Widowed

Divorced

If married, list your spouse’s name:

If married, anniversary date:

Children?

If yes, please list their name and age:

Occupation:

How long have you been attending the Ministry?

Have you given your life to Jesus?

Have you declared your faith in Jesus publicly through water baptized?

Have you attended our Vision in Motion Class?

Can you briefly share your experience at theREACHcentre?

For example: What brought you here? What keeps you here? What’s been your experience?

If you are coming from another church, can you briefly explain the reason behind that decision. Did you leave/transition in good standing?

Are you interested in joining a ministry?

Guest Services

Children

Youth & Young Adults - REACHnxt

Health Services

Finance

Praise & Worship/Band - RIW (REACHinWorship)

Events

Social Media

Streaming Media/Sound Engineer

Small Groups

Prayer & Intercession

Administration

Community Services

Marriage Ministry

REACHcare

REACHmen - men's ministry

REACH(her) Women's Ministry

How did you hear about us?

Family

Friend(s)

Online

Social Media

Website

May we contact you?

I certify that the information is complete and accurate to the best of my knowledge.

I also acknowledge that my membership is not confirmed until I have completed the New Member Orientation.