Immanuel Connect Card
We're so glad you have joined us today! Fill out the card below so we can find out more about you!
Email address *
Name: *
Address: *
City *
State *
Phone Number *
Would you like to receive text updates? *
What age group are you in?
Clear selection
(If you are a student) What Grade are you in?
Clear selection
Are you married?
Clear selection
Do you have children living at home with you? What are their names? How old are they?
Would you like to speak to a minister about any of the things below?
Prayer Needs: (Please specify if this is confidential)
What service did you attend?
Would you like information about any of the following?
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Immanuel Baptist Church. Report Abuse