Request edit access
New Convert Participation Form
Congratulations!  If you said the prayer of salvation during the service you are now a child of God. Please fill the form below. We would like to know you and also send you a free E-Book titled "Now That You Are Born Again" by Pastor Chris
Sign in to Google to save your progress. Learn more
First & Last Name *
Email
Phone Number (Optional)
Which country and city are you participating from? *
How did you hear about us?
What is the best way to contact you?
Clear selection
Kindly state any comments, prayer points or questions you may have
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of CHRIST EMBASSY NEW YORK. Report Abuse