Care Ministry Intake Form - New Life Pentecostal Assembly

Telephone visits will be completed on a one-to-one basis. In-person visits will consist of teams of two. Visits will be approximately 1-2 hours once a month. Please add an additional comment if requiring additional visits.

Phone number

Age Range *

Under 18

18-35

36-64

64+

Preferred method of contact *

Telephone

In person

Best time to contact

Morning

Afternoon

Evening

Preferred type of visitation *

Telephone

In person (must be Brant County resident)

Preferred gender of volunteer visitor *

Female

Male

No preference

Please check off all that apply. I would like a visit for: *

I am new to the church

Social engagement

Prayer

Other

Additional comments