Connect Card

First Name

Last Name

Email

Phone Number

Address

Apartment, suite, etc.

City

State

Postal / Zip Code

Include spouse's information

Yes

No

Spouse's First Name

Spouse's Last Name

Spouse's Email

Spouse's Phone Number

Check all that apply:

I made a decision to accept Jesus as my Savior today.

I would like to talk to someone about baptism.

I would like info about Adult Groups.

I would like info about kids and students ministry.

I would like to know more about serving.

Questions, Comments, Prayer Requests: