Access Victory

AgeGroup:	16-19	20-29	30-39	40-49	50-59	60 & over
Marital Status	Single	Married	Divorced	Separated	Widow(er)

Name:

Male  Female

Birth Date:

        

Address:      Apt.#:

City:      State:   Zip:

E-mail:

Home Phone:      Cell Phone:   Work Phone:

Please provide the names & birthdays of children 15 and younger - living at home. Please note: Children age 15 and younger will automatically become members under their parents, age 16 and older will need to take the membership class in order to be listed as a member of the church.
Child Name:      Birth Date:	Will you need childcare for class? Yes No

I.	General Background	Male	Female
1.	We are a church that celebrates the number and variety of nationalities represented in our congregation, and we’d like to include yours! Of which nationality(ies) do you consider yourself a member of?
2.	Do you speak any other languages fluently?
3.	What do you do for a living?
4.	Special skills/hobbies:	carpentry sewing/crafts drama website development floral computer programming faux finishing/painting publication public relations other	carpentry sewing/crafts drama website development floral computer programming faux finishing/painting publication public relations other
5.	Religious background?
6.	When did you receive Christ as Lord & Savior?	Month Year	Month Year
7.	Have you been water baptized since you were saved?	Yes No	Yes No
8.	Have you been baptized in the Holy Spirit with the evidence of speaking in tongues?	Yes No	Yes No
9.	Have you ever volunteered in other churches?	Yes No	Yes No
	a. If yes, Church name
	How long did you attend?
	b. List any duties performed and time served
10.	Have you served in any of VWC's Ministries?	Yes No	Yes No
	a. If yes, list areas/responsibilities.
11.	What/Who brought you to VWC?
12.	How long have you attended VWC?
13.	Based on your perspective of Victory
	a. What is the one thing you like best about VWC?
	b. In what areas can we change/improve?