Binkley Church Online Friendship Register

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Please let us know you worshipped with us today by providing your name(s) below. If you are a first-time guest, please leave us your contact information so we can get to know you better. At the bottom of this form you will also find a place to share information or prayer requests with our staff. All information is secure and confidential and will only be seen by Binkley staff.

First Name(s)

Last Name(s)

Which service(s) did you attend/view today? Type in date(s) below.

What platform did you use to attend/view our service?

In-person

Facebook

YouTube

binkleychurch.org

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Are you a first-time guest? If so, please check 'Yes' and leave us your contact info below. We look forward to getting to know you better!

Yes, I am a first-time guest

I am a returning guest

I am a Binkley Member/Friend

Mailing Address (optional)

If you'd like to receive updates about Binkley and our activities and events, please give us your e-mail address.

Phone Number

How did you hear about Binkley?

Friend

Website

Social Media

Drove by campus

Print media

Other:

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Would you like to submit a prayer request, or is there anything you'd like for us to know? This information is secure and confidential and will only be seen by Binkley staff.

Submit

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