Connection Card

Tell us about yourself...

Tell us your Name:
Marital Status: Married
Single
Other
Are You?: Male
Female
Address:
City/State/Zip:
Phone #:
Email Address:
I have attended a Connection Church Service... Have Not Attended
One Time
Two Times
Three Times
I am a regular attendee
Membership Status... I am a Member
I would like to join Connection Church
I am interested in joining a Connection Group
My age group... 11 - 14
15 - 18
19 - 22
22 - 30
31 - 40
41 - 59
60 - 69
70 +
Names and ages of your children?
How did you hear about Connection Church?
My Decision Today - I Am... ...committing my life to Christ
...renewing my committment to Christ
...wanting to be baptized
...requesting a visit with a Pastor
Do you have any comments that you would like say?
  
 



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