Impact Church Digital Connection Card

IMPACT CONNECTION CARD
First Name*
Last Name*
Date*

MonthDayYear
Date
Birth Month, Birth Year
Email*
example@example.com
Which of these apply to you?*

First Time ViewerSecond Time ViewerAttend RegularlyWatching Online
Prayer Request
Testimony
If you are new to Impact Church or you have a change in your contact information please continue and fill out the rest of our connection card. If not hit send now!

Address*
APT, Suite, Other
City*
STATE*
COUNTRY*
Zip*
Phone Number*
E-mail Address*
My decision today?*

I am committing my life to ChristI am renewing my commitment to Christ
E-mail*
Are you a new or existing member of Impact Church?

New MemberExisting Member
Should be Empty:

IMPACT CONNECTION CARD