Flourish Mentee Application
Groups Begin on September 8, 2025
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birthdate
*
-
Month
-
Day
Year
Date
Marital Status
*
Please Select
Single
Married
Divorced
Widowed
If married, how many years?
Do you have children?
*
Yes
No
Do you have children? If yes, list names and ages:
Do you call FBC Palmetto your home church?
*
yes
no
Have you completed the membership class at FBC Palmetto? Or are you registed for the next class?
*
I've completed the membership class
I'm registered for the next class
I'd like to know more about this class
I have not taken the class
If you have placed your faith and trust in Jesus, please share how and when you began to follow Him with your life:
*
Please briefly describe the current season in your relationship with Jesus:
*
Why do you desire to be part of the Flourish Women's Mentoring?
*
What are your expectations of your mentors?
*
I commit to accountability with my mentors and mentoring group:
*
Yes
No
I commit to attend the required Flourish kick-off gathering for this group.
*
Yes
No
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Flourish Mentee Registration & Materials
$
20.00
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Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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