Connection Card

C O N N E C T I O N C A R D

* Indicates required field

NAME *

First

Last

GENDER *

Male Female

MARITAL STATUS *

Married Single Other

DATE OF BIRTH *

ADDRESS *

Line 1

Line 2

City

State

Zip Code

Country

_ *

THIS IS AN UPDATED ADDRESS

PHONE NUMBER *

EMAIL *

ARE YOU A FIRST TIME GUEST? *

Yes No

HOW DID YOU CONNECT WITH US TODAY? *

At the in-person GCCC location Online Service At a Small Group Need Prayer

MY DECISION TODAY *

I am committing my life to Christ I am renewing my commitment to Christ I want to be baptized I would like to talk with a ministry team member

PRAYER REQUESTS *

For Prayer Team Confidential

PRAYER REQUEST *

Submit

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