Connection Card
Please fill out this form and click submit.
Date
*
Visit
*
Please select one option.
1st
2nd
3rd
Name
*
Spouse Name
*
Email
*
This address will receive a confirmation email
Phone
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Your age group
*
Please select all that apply.
Under 20
20s
30s
40s
50+
Children and their age
*
How did you hear about us?
*
Please select all that apply.
Website
Facebook
Friend
Instagram
Family member
Other
What's next?
"So in Christ we, though many, form one body, and each member belongs to all the others" -Romans 12:5
Start
*
Please select one option.
I dedicated my life to Christ for the first time
I re-dedicated my life to Christ
Select Option
I dedicated my life to Christ for the first time
I re-dedicated my life to Christ
Next Step
*
Please select one option.
I'm interested in getting baptized
I'm interested in joining a small group
I would like to talk to a pastor
Select Option
I'm interested in getting baptized
I'm interested in joining a small group
I would like to talk to a pastor
Get Involved
*
Please select one option.
I want to become a member
I want to volunteer for a ministry
I would like to be contacted by a leader
Select Option
I want to become a member
I want to volunteer for a ministry
I would like to be contacted by a leader
Prayer Request/ Questions
*
Submit
Description
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