CONNECT CARD | Jesus' Disciples Family Church

Last Name (Required)

First Name(s) (Required)

List all names of your family members separated by commas (ie. John, Mark, Mary).

Date of Birth

Mailing Address (Required)

City / State / Zip (Required)

Phone Number (Required)

Email Address (Required)

Martial Status (Required)

Which ministry in the church is best fitting for you (ie. Men's, Women's, Youth, Children).

I am a ... (Required)

Prayer Request | Praise Report

Prayer requests and/or praise reports are prayed over by the pastor.

I am interested in ... (Required)

This will help us determine your interests in order to better serve you.

Salvation

Baptism

Membership

Discipleship

Small Groups

Counseling w/ Pastor (1 on 1, couple, marriage, family, etc.)

How did you hear about us?

To better our reach, your input on how you heard about us will help our Media Ministry determine the best method of marketing.

Jesus' Disciples Family Church