Discipleship Mentorship Program

Life Touch Ministries NFP Life Touch Community Church Touching Lives · Transforming Destinies

Form 1 of 2 - Mentor Application

8-Week Discipleship Mentorship Program

For Mature Life Touch Members Seeking to Disciple New Converts

"And the things that you have heard from me among many witnesses, commit these to faithful men who will be able to teach others also." - 2 Timothy 2:2 (NKJV)

Please complete all required fields marked with * before submitting.

Thank you for your interest in serving as a Mentor in the Life Touch Discipleship Mentorship Program. Please complete all sections fully and honestly. This application will be reviewed by the Discipleship Coordinator and pastoral leadership. Submission does not guarantee placement. All applicants will be contacted within two weeks of submission.

Personal Information

Full Name *

Date of Application *

Phone Number *

Email Address *

Home Address - Street, City, State, ZIP *

Date of Birth

Gender

Marital Status

Spouse's Name (if applicable)

Life Touch Church Involvement

How long have you been attending Life Touch?

Are you a Life Touch Member?

Have you completed the following? (Check all that apply)

Life Touch Membership Class Water Baptism at Life Touch 1-1-1 Evangelism Training Workshop A previous discipleship / mentoring course

Current Ministry Area(s) at Life Touch

Sunday Service Attendance

Midweek Attendance

Spiritual Background & Character

When, where, and how did you give your life to Jesus Christ? *

Describe your current spiritual disciplines

How consistently do you pray, read the Bible, fast, and attend church?

Describe a time you helped someone grow in their faith

Mentoring Readiness

Why do you want to serve as a Mentor in this program? *

What spiritual gifts or strengths do you bring to a mentoring relationship?

Commit to 8 consecutive weekly sessions? *

Preferred days/times for sessions

Schedule constraints or limitations we should know about?

Prior experience mentoring, discipling, or coaching others?

Yes - I have prior experience (describe below) No - this would be my first time

Specific type of Mentee you feel best equipped to disciple?

Men only Women only Young adults (18-25) Adults (26-45) Any age / No preference

Statement of Faith Affirmation

Life Touch Ministries NFP holds to a clear Statement of Faith. All Mentors are required to fully affirm these core beliefs. Please type your initials in the box beside each statement. If you have questions, contact the Discipleship Coordinator before completing this section.

2 Tim. 3:16-17I believe the Holy Bible is the inspired, inerrant, and authoritative Word of God.

Initials

Matthew 28:19I believe in one God, eternally existing as Father, Son, and Holy Spirit.

Initials

I believe in the virgin birth, sinless life, death, resurrection, and return of Jesus Christ.

Initials

Acts 1:8; 1 Cor. 12:4-11I believe in the present-day ministry and gifts of the Holy Spirit.

Initials

Ephesians 2:8-9I believe salvation is by grace alone, through faith alone, in Christ alone.

Initials

I believe in the local church as essential for discipleship, worship, and evangelism.

Initials

Matthew 28:18-20I affirm the Great Commission as the responsibility of every believer.

Initials

I am currently living in alignment with these beliefs to the best of my ability.

Initials

Pastoral / Character References

Please provide two references - one pastoral/ministry leader and one fellow church member (not a family member) who can speak to your spiritual maturity and character.

Reference One - Pastoral / Ministry Leader

Full Name *

Relationship to You *

Phone

How long have they known you?

Reference Two - Fellow Church Member

Full Name *

Relationship to You *

Phone

How long have they known you?

Disclosure & Consent

Please answer the following honestly. All answers are confidential.

Are you currently involved in an unresolved disciplinary matter with Life Touch leadership?

Yes - please explain below No

Is there anything in your current life that might limit your availability or effectiveness as a Mentor?

Yes - please explain below No

By signing below, I affirm that all information provided in this application is true and accurate. I understand that serving as a Mentor is a ministry role that requires consistency, confidentiality, and Christlike character. I agree to maintain confidentiality regarding all information shared by my Mentee and to immediately notify the Discipleship Coordinator if any pastoral concern arises. I understand that Life Touch leadership reserves the right to decline or terminate my service as a Mentor at their discretion.

Applicant Signature *

Sign here with mouse or finger

Print Name * Date *

For Office Use Only

Application Received

Reviewed By

Decision

Date of Decision

Assigned Mentee

Start Date

Notes

How to Submit: Complete all fields, then click the button below. Use Print → Save as PDF to save, then email your PDF to info@lifetouchcommunity.com | Subject: "Mentor Application - [Your Name]"
Questions? Call (815) 552-1242

Please complete all required fields marked with * before submitting.

Welcome to Life Touch! We are thrilled you have said yes to Jesus. This form helps us understand your background and connect you with the right Mentor for your 8-week discipleship journey. There are no wrong answers - just be honest. Everything you share is kept confidential.

Personal Information

Full Name (First, Last) *

Date of Application *

Phone Number *

Email Address *

Home Address - Street, City, State, ZIP *

Date of Birth

Gender

Best Time to Contact

Occupation / School

Preferred language for sessions

English Spanish French Other

How You Came to Life Touch

How did you first hear about Life Touch Community Church?

Through a Life Touch member (1-1-1 Outreach) Invited by a friend or family member Online / Social Media / Website Church event or outreach Walked in on my own Other

Name of the Life Touch member who invited you

This helps us connect you with the person who reached out to you.

How many times have you attended Life Touch?

Have you attended any Life Touch events?

Your Faith Journey

Have you made a personal decision to accept Jesus Christ as your Lord and Savior?

Yes - recently (within the last 3 months) Yes - within the past year Yes - more than a year ago, but I am new to discipleship I'm still exploring / not sure yet

Briefly describe your faith journey or what you are exploring

There's no perfect way to write this. Just share your story.

Do you have a previous church background?

Yes No

Church / Denomination and for how long

Current Spiritual Practices

Which of the following are you currently doing? (Check all that apply)

Reading the Bible regularly Praying daily Attending Sunday services Attending midweek service Part of a small group None of the above yet

Do you own a Bible?

Yes - NKJV Yes - another translation No - I need one

What is your biggest question or challenge about the Christian life right now?

Mentorship Preferences

What are you most hoping to get out of this 8-week program? (Check all that apply)

Understanding the basics of Christian faith Building a consistent prayer and Bible habit Finding community and belonging at Life Touch Understanding how to share my faith Learning about the Holy Spirit Growing in Christian character All of the above Something specific (describe below)

Preferred day(s) for weekly sessions

Preferred time(s)

Session format preference

Mentor gender preference

Anything specific about your background your Mentor should know?

Optional but helps us match you thoughtfully. All information is confidential.

Program Commitments

The 8-Week Discipleship Mentorship Program is most effective when participants are fully committed. Please check each box to indicate your agreement.

I commit to attending all 8 weekly sessions with my assigned Mentor. I commit to completing each week's assignment to the best of my ability. I commit to memorizing each week's Scripture verse. I commit to attending Life Touch Sunday and midweek services during the program. I commit to being honest and open with my Mentor about my struggles and questions. I commit to treating all information shared in sessions as confidential. I commit to completing the Membership Class at Life Touch during or after the program. I understand that missing two or more sessions without communication may result in program deferral.

Parent / Guardian Consent (Complete only if applicant is under 18)

If the applicant is under 18 years of age, a parent or legal guardian must complete and sign this section.

Parent/Guardian Full Name

Relationship to Applicant

Parent/Guardian Phone

Parent/Guardian Email

I, the undersigned parent/guardian, give my consent for the above-named minor to participate in the Life Touch 8-Week Discipleship Mentorship Program. I understand that all sessions will be conducted in appropriate, supervised settings and that Life Touch pastoral leadership maintains oversight of this program.

Parent/Guardian Signature

Sign here with mouse or finger

Date

Applicant Agreement & Signature

By signing below, I confirm that all information in this application is accurate. I understand that this program is designed to help me grow in my faith and integrate into the Life Touch community. I agree to participate honestly and consistently, and I understand that my Mentor and the Life Touch Discipleship Coordinator are here to support - not judge - my journey.

Applicant Signature *

Sign here with mouse or finger

Print Name * Date *

For Office Use Only

Application Received

Reviewed By

Decision

Assigned Mentor

Start Date

Bible Provided?

Notes

How to Submit This Application

? In Person: Life Touch Welcome Desk - 13242 S. Route 59, Lower Level, Ste. B100, Plainfield, IL 60585

✉️ Email: Scan/save as PDF and send to info@lifetouchcommunity.com - Subject: "Mentorship Application"

? Phone: Call (815) 552-1242 and we will assist you

All applications are reviewed within 14 business days. You will be contacted personally by the Discipleship Coordinator with next steps.

How to Submit: Complete all fields, then click below. Use Print → Save as PDF to save your completed form, then email it to info@lifetouchcommunity.com
Questions? Call (815) 552-1242

Life Touch Community Church | 13242 S. Route 59, Lower Level, Ste. B100, Plainfield, IL 60585 | (815) 552-1242 | info@lifetouchcommunity.com | www.lifetouchcommunity.org

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