Connection Card

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Date

*

Name

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Spouse's Name

Address

Phone

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Spouse's Phone

Email

*

Age

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Please select one option.

under 19 20-29 30-39 40-49 50-59 60+

Do you have children?

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Yes No

Children's Ages

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0-5 6-11 12-18

Please check any box that would apply to your visit with us today:

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First Time Guest Returning Guest Current Member

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Please select all that apply.

I would like to learn more about having a personal relationship with Jesus Christ I would like to learn more about baptism I would like to learn more about VBC

Additional Notes:

Description

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