Date *

MM

DD

YYYY

Name *

First Name

Last Name

Spouse's/Partner's Name

First Name

Last Name

Phone

(###)

###

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What are you looking for in a church? (Check all that apply.)

Missions/Service

Music Ministry

Fellowship

Faith Formation

Children's/Youth Ministry

Join the church, profess my faith, or get baptized

How can we support you on your journey? (Check all that apply.)

A minister reaching out to me.

Grab a coffee and chat.

An occasional call, email, or note.

Pray for me or a loved one.

Keep me in the loop/invite me to relevant events.

Other (Let us know below!)