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
Ownership Position

Other
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
2 digit month, 2 digit day, 4 digit yearDate
Spouse's Name (if married)

First NameLast Name
Anniversary (if married)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
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.
Has your C12 Chair explained the monthly billing process to you?
Accounting Email
This is the email address you prefer for invoices from C12 North Texas.
Select the C12 Forum that you wish to join.
Membership Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearThe month indicated represents your first billing month.
C12 Membership Agreements (please check all)
What do you personally need most from C12? (check all that apply)

Other
Where do you need improvement and accountability most? (check all that apply)

Other
What would you like most to improve in your company? (check all that apply)

Other
Which statement best describes your strategic planning process? (select the best option)
What describes how you integrate your Christian faith and business today? (check all that apply)

Other
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
Should be Empty:

New Member Application