C12 New Member Registration

New Member Application
Qualification/Calling

C12 membership is limited to Christians who are business owners, CEOs, Presidents, or business unit general managers with responsibility for at least 5 employees.
Full Name*

First NameLast Name
How did you hear about us?*
Please select best option
Please tell us how you heard of C12.*
Mobile Number*

Area CodePhone Number
E-mail*
Where do you regularly worship?*
Please enter the name of your church
Organization Name*
Business Title*
E.g., Owner, CEO, President
Sole OwnerMajority OwnerCEO (without ownership)PartnerOther
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Approximate Annual Revenue*
Number of Employees*
FTE Equivalents, W-2 & 1099
Business Description*
Briefly describe the industry/market that you serve
Birthday*

MonthDayYear
Date
Spouse's Name (if married)

First NameLast Name
Anniversary (if married)

MonthDayYear
Date
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Membership Basics
Members meet monthly on a regular day (e.g., the 3rd Thursday of each month) and commit to faithful attendance. This is defined as attending at least 10 of 12 monthly meetings yearly and avoiding absence at two consecutive meetings. As an interactive peer community of believers, the effective functioning of group relationships relies on the stability, timeliness, and understanding which accompany faithful attendance and transparency. As CEOs, members generally have sufficient control over their calendars to enable such participation. Each month, each member will select a mutually agreeable time/location (e.g., workplace) to meet for 60-90 minutes with their C12 Chair for a Focus60 discussion and counsel.
One time registration fee.*
Your C12 Chair will supply you with this number.
Monthly membership fee.*
Your C12 Chair will supply you with this number.
YesNo
Accounting Email*
This is the email address you prefer for invoices from C12 North Texas.
Addison (Third Thursday)Allen (Third Wednesday)Bent Tree (Third Wednesday)Carrollton (Second Friday)Collin (Third Friday)Frisco (Fourth Wednesday)IKE (Third Friday)Maridoe (Third Thursday)Maridoe (Third Wednesday)Richardson (Third Thursday)Sam Rayburn (Third Tuesday)Stonebriar (Third Tuesday)Teleios (Third Thursday)Tollways (Second Friday)Village Creek (Second Tuesday)Waco (Fourth Thursday)Waco (Third Tuesday)Waco (Third Wednesday)
Membership Start Date*

MonthDayYear
The month indicated represents your first billing month.
C12 Membership Agreements (please check all)*

I agree that I do/will fulfill the requirements of the membership basics.I agree to hold member information confidential and avoid solicitation, doctrinal disputes and behavior contrary to C12's core principles.I understand that membership auto-renews and that all fees must be current.If I decide to terminate my membership, I promise to express my intentions and reasons to my peer group during my final meeting.I understand that breaching C12’s stated core principles and standards will result in cancellation of my membership.I affirm the C12 doctrine statement and agree to refrain from divisive behavior while embracing the pursuit of God’s best in all things according to the Bible.With these agreements, I desire to become a C12 member.
What do you personally need most from C12? (check all that apply)*

A trusted community of peersA safe place to discuss complicated issuesA rhythm of reviews to hold me accountableTraining in my weak areas of leadership/managementExposure to other businesses and leadersEncouragement for the difficulties of life and workSupport to live out my faith more consistentlyPrayer for me, my family, and my companyI don’t knowOther
Where do you need improvement and accountability most? (check all that apply)*

MarriageFamily relationshipsFitness/nutritionPhysical RestSpiritual RetreatPersonal FinancesWalk with GodOther
What would you like most to improve in your company? (check all that apply)*

Financial ManagementRevenue Generation (sales, business development)OperationsOrganizational DevelopmentMinistryEverything is great – no changes neededOther
There are too many distractions to develop a plan.We have a plan, but it is reviewed infrequently.Our strategic goals are unrealistic and unfocused.We have an effective plan that we work on consistently.We tried planning, but it did not work for us.We are unsure how to create a strategic plan.
What describes how you integrate your Christian faith and business today? (check all that apply)*

There is no integration todayI prefer to keep my faith personalWe give to charitable organizations with business fundsWe support community-based servicesWe are developing our plans for ministry through the businessWe have ongoing plans for business as a ministryWe track and review KPIs for ministryOther
FOR C12 CHAIR PROCESSING (no input required from member)
- Registered new member with C12 Headquarters (C12App)
- Added new member to forum email list
- Created and send initial invoice
- Added a recurring invoice
- Delivered C12NT New Member folder
- Notified forum that new member joined
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New Member Application