Connect Card

Your name *

Last name

Email address *

Reason for filling out the Connect Card *

You can select more than one option.

I dedicated my life to Christ today

I would like to learn more about a relationship with Jesus

I would like to talk with a pastor

Guest

Other

Which service did you attend *

Saturday 5:30pm service

Sunday 9am service

Sunday 11am serivce

Online

Have not attended yet

Phone number *

Phone type

MobileHomeWorkOther

How do you prefer to be contacted? *

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Email

Phone call

Text message

Marital status

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Address

HomeWorkOther

Country

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Prayer request and comments

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