CPC East Campus Discipleship Survey

Thank you for taking time to fill out this brief discipleship survey. Our goal is to gather information that will assist in current and future discipleships.

Name

*

Phone

*

Email

*

This address will receive a confirmation email

Gender

*

Please select one option.

Male Female

Connect Group

*

Please select one option.

Beard Boswell College Connect Finley Mabley Parsons Peters Short Steelman Student Connect Swartwout Vellios Wade Wilson Withers I'm not currently in a Connect Group

Age

*

Are you currently discipling?

*

Please select one option.

Yes No

Please list the names of people you are currently discipling:

Would you like to disciple others?

*

Please select one option.

Yes No

If you aren't currently discipling others, would you like to be trained to disciple others?

*

Please select one option.

Yes No

Are you currently being discipled?

*

Please select one option.

Yes No

Please list who is currently discipling you:

Would you like to be discipled (if you aren't currently being discipled)?

*

Please select one option.

Yes No

Description

Thank you for taking time to fill out this brief discipleship survey. Our goal is to gather information that will assist in current and future discipleships.

Please Fix the Following

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