Connection Card
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Name:
*
Your answer
Address:
*
Your answer
City, State, Zip:
*
Your answer
Cell Phone:
*
Your answer
Email:
*
Your answer
Date of Birth:
*
MM
/
DD
/
YYYY
Are you a:
*
1st Time Visitor
2nd/3rd Time Visitor
Regular Attender
Covenant Member
People in your household:
Husband/Wife
Your answer
Date of Birth
MM
/
DD
/
YYYY
Child 1 (if applicable)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Child 2 (if applicable)
Your answer
Date of Birth
MM
/
DD
/
YYYY
Do you attend Church regularly
*
Yes
No
If so, Where?
Your answer
I am a guest of:
Your answer
My decision today :
Commit my life to Christ
Renew my commitment to Christ
Be Baptized
Request a pastoral visit
Covenant Class information
More info about CCW
Need a ride to church
I would like to serve in the following area(s):
Food Prep
Meal Server
AWANA
Nursery/Children's Ministry
Worship Team
Sound & Media Team
Student Ministry
Missions (local & global)
Visitation Team
Hospitality Team
Prayer Team
Usher Team
Greeter Team
Setup/Breakdown Team
Welcome Team
Lead a Small Group
Host a Small Group
Prayer Needs - (List New or Updated request)
Your answer
Do you want your prayer request kept Confidential among the council and staff?
Yes
No
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