Corinth 101 Intro Form – Corinth Reformed Church

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Your Information

Please complete this section with information about yourself. If you are attending the class with a spouse/partner who lives with you, you will add his/her info soon.

Your Name *

First

Last

Your Gender *

Male
Female

Your Date of Birth *

Your Email *

Preferred Phone *

This number is... *

My Cell Phone
My Home Phone
My Office Phone
Another Kind of Phone Number

What kind of phone number is it? *

Home Address (physical address) *

Address Line 1

Address Line 2

City

State

Zip Code

Do you use a mailing address that is different from your physical address? *

Mailing Address (if different from physical address) *

Address Line 1

Address Line 2

City

State

Zip Code

Which best describes your current marital status? *

Single
Engaged
Married
Separated
Divorced
Widowed
Other

If planned, please provide your anticipated wedding date

Please use this space to tell us if there other ways you are expecting/hoping we can help you with your wedding. (Venue for ceremony and/or reception, pastor to officiate, premarital counseling, music for ceremony, etc.)

When were you married?

Please use this space to share any information that you feel our pastors should know about your separation/divorce

Please use this space to share any information that you would like our pastors to know about your spouse (name, anniversary date, date of death, or any other details you wish to share)

Explain briefly what you mean by "Other" *

Do you have a spouse/partner in your household? *

Family Info

Please use this section to tell us about your family.

Spouse/Partner's Name *

First

Last

Spouse/Partner's Gender *

Male
Female

Spouse/Partner's Date of Birth *

Spouse/Partner's Email

Spouse/Partner's Phone

This number is

A Cell Phone
A Home Phone
An Office Phone
Another Kind of Phone Number

What kind of phone number is it?

Do you have any dependent children living with you in your household? *

For this question, we want to know about minor children and/or adult children with special needs who reside with you. Please select "no" to this question if your children are college-aged or young adults who live with you. We will give you a chance to tell us about them later!

Child Information

Please tell us about your child(ren). We use this information to identify age-specific ministries and events that may be of interest to your family. You may skip this page if you do not have children living in your home.

Child's Name *

First

Last

Child's Gender *

Male
Female

Child's Date of Birth *

Child's School & Grade (if applicable)

Has this child been baptized? *

When/where was this child baptized? (An approximate date is fine)

You may use this space to share any additional information about this child that you feel we should know at this time.

Is there a second child in the home? *

Second Child's Name *

First

Last

Second Child's Gender *

Male
Female

Second Child's Date of Birth *

Second Child's School & Grade (if applicable)

Has this child been baptized? *

When/where was this child baptized? (An approximate date is fine)

You may use this space to share any additional information about this child that you feel we should know at this time.

Is there a third child in the home? *

Third Child's Name *

First

Last

Third Child's Gender *

Male
Female

Third Child's Date of Birth *

Third Child's School & Grade (if applicable)

Has this child been baptized? *

When/where was this child baptized? (An approximate date is fine)

You may use this space to share any additional information about this child that you feel we should know at this time.

Is there a fourth child in the home? *

Fourth Child's Name *

First

Last

Fourth Child's Gender *

Male
Female

Fourth Child's Date of Birth *

Fourth Child's School & Grade (if applicable)

Has this child been baptized? *

When/where was this child baptized? (An approximate date is fine)

You may use this space to share any additional information about this child that you feel we should know at this time.

Are there any additional children in your household? *

We think you know what we're looking for by now! Please provide the same information requested above for any additional children in your home. *

Your Story

What is/are your occupation(s)?

Approximately how long have you been attending Corinth? *

0-6 months
6-12 months
1-3 years
3+ years

If you have a church background, what church did you attend before coming to Corinth?

Which Corinth worship service(s) do you normally attend?

8:30 Sonrise (blended)
11:00 Traditional
11:00 Contemporary

If you are currently involved with any small groups (Bible studies, classes, etc.) at Corinth, please list them below.

Do you have any family members at Corinth? If so, please share their names and your relationship to them.

Do you have any friends who are Corinth members? If so, please share their names and the nature of your relationship with them.

If you have adult children or other significant relationships that you would like us to be aware of, please share about them here.

Do you have any special concerns or comments to share with our pastors at this time?

Photo

Please upload a photo to help our pastors and staff learn your names/faces. Don't panic. We get it. A lot of people don't like being in photos and don't like the way they look in pictures. This is not a beauty contest; this is a tool to help us get to know you. Please pick something CURRENT and CLEAR.

Photo

Click or drag a file to this area to upload.

Be wise in your photo selection. Would someone who has never met you before be able to easily identify you from this photo?