Connect- Membership Class, Jun 13 2021
* First Name
* Last Name
* Mobile Phone
* Email
* Address
* Age Categories
Select one
Student (17 & under)
Adults (18-24)
Adults (25-39)
Adults (40-55)
Adults (56-70)
Adults (70+)
Unknown
* Marital Status
Select one
Single
Married
Divorced
Separated
Widowed
* T-Shirt Size
Select one
Youth XS
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Adult XXXL
Adult XXXXL
* Have you accepted Jesus as your Savior? Describe your story.
* Have you been baptized?
Select one
Yes
No
If Yes, enter date or age
If No, would you like to speak to a pastor about being baptized?
Select one
Yes
No
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