Preliminary Questionnaire
Begin your adventure of “Serving Those Who Serve Others” by becoming an Associate or RV’er for Christ by completing this simple form.
Your Name (required)
Nickname
Gender (required) MF
Occupation
Marital Status (required) SingleMarriedDivorcedSeparatedWidowed
Anniversary Date
Spouse Name
Spouse Nickname
Spouse Gender MF
Spouse Occupation
Home Address (required)
City (required)
State (required)
Zip (required)
Home Phone (required)
Cell Phone
Email (required)
What is your preferred method of contact? Regular MailE-MailText
North West - WA OR ID AKBlue Sky - ND SD MT WYHeartland - AR KS MO IA NESouth Central - LA TX OKMid Atlantic - PA MD DE DC VA WV KYGolden State - CA NV HIFour Corners - NM AZ UT COGreat Lakes - OH IN MI IL WI MN - CA NV HINorth East - NY NH VT ME MA CT RI NJSouth East - NC SC GA AL TN MS FL
Name of Your Church (required)
Denomination
How long have you attended there? (required) Less than a year1-3 years3-10 yearsMore than 10 years
Briefly tell us about your interest in serving the Lord through CWCf (required)
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