Walking in Harmony "Mentor" Form | Northeast Baptist Church

Name (Required)

Email Address (Required)

Todays Date (Required)

Birthday (Required)

Address (Required)

Your Phone Number (Required)

Communication Preference (Required)

Email

Text

Audio Call

When is the best time of day to call? (Required)

Mondays after 5pm; Thursdays after 10am; Sunday afternoons only, Anytime, etc.

Marital Status (Required)

Single

Dating

Engaged

Married

Widowed

Divorced

Blended Family (Required)

Children / Grandchildren Name(s), Age(s) (Required)

If not applicable , "N/A"

Where do you like to meet? (Required)

For example, at a park, a restaurant, etc.

Is your home your sanctuary or do you enjoy having guests? (Required)

Profession (Required)

Retired, Mom, Grandmother, Teacher, Admin Assistant, etc.

How many years have you been a member of NEBC? (Required)

Do you attend: (Required)

Sunday School

Lifegroups

Both

None Currently

Other Church Activities (Required)

Salvation Experience (Required)

Brief Description

Main Love Language (Required)

Acts of Service

Receiving Gifts

Quality Time

Words of Affirmation

Physical Touch

Do you lean more Introverted or Extroverted (Required)

Introverted

Extroverted

Personality Traits (Required)

Type A - The Director (goal-oriented, risk taking, good under stress)

Type B - The Socializer (relationship-orienter, outgoing, enthusiastic)

Type C - The Thinker (detail-oriented, logical, prepared)

Type D - The Supporter (task-oriented, stabilizing, cautious)

Interests, Hobbies, Talents, Desires, Needs, Hopes, Passions (Required)

What situations, or struggles has the Lord allowed in your life that you could share in this relationship? (Required)

Other pertinent information that would help the determination of a complimentary partner.