CONNECT CARD

Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date Of Birth

MM

DD

YYYY

Are you a first time guest?

Yes

No

My Decision Today

I am committing my life to Christ

I am renewing my commitment to Christ

I want to be baptized

I would like to talk with a ministry team member

I am a first time guest and would like to learn more