Growing Deeper Roots - Registration Form

Your Name*

Date*

MonthDayYear

Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Your Primary Phone*

Area CodePhone Number

Your Secondary Phone

Area CodePhone Number

Your E-mail

Please help us to get to know you better. There are no right or wrong answers. This remains confidential.

Have you attended Alpha?

YesNo

Do you have a personal relationship with Christ?

YesNo

If Yes... how long?

0 - 1 Years2 - 5 Years6+ Years

Are you or have you been in a Bibile Study?

YesNo

Are you or have you been in a Small Group?

YesNo

Check all that apply...

I read the Bible often.I read the Bible once in a while.I want to learn more about the Bible.I like learning about Bible land and history.I want to know how to get a new heart.I'm interested in understanding my new heart better.I want to learn how to have a more intimate relationship with Christ.I want to learn some tools to help me grow in my relationship with Christ.

Registration Fee is $5.00*

I will bring the fee to the first night of the programI have sent in payment to VCNW, 9165 Round Top Rd, Cincinnati, OH 45251Please cover my registration fee from the scolarship fund

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* Indicates Respose Required Vineyard Church Northwest Effective 2/15/2011