Grace Church Online Connect Card
We want to connect with you! By sharing a little about yourself, we're better able to know and care for you.
Please check all that apply.
This is my first time at Grace.
I want to start a relationship with Christ.
I am renewing my commitment to Christ.
I would like to be contacted by a ministry team member.
I need to update my address/phone information.
Your Name
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First Name
Last Name
Your Date of Birth
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Month
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Day
Year
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Spouse Name
First Name
Last Name
Spouse Date of Birth
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Month
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Day
Year
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Address
Street Address
Street Address Line 2
City
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Cell Number
Home Phone Number
E-mail
example@example.com
Spouse Cell Number
Spouse E-mail
example@example.com
Family Information
Child's Name
First Name
Last Name
Child's Date of Birth
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Month
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Day
Year
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Click all that apply
Allergies
Special Needs
Child's Grade
Child's Name
First Name
Last Name
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Allergies
Special Needs
Child's Date of Birth
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Month
/
Day
Year
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Child's Grade
Child's Name
First Name
Last Name
Click all that apply
Allergies
Special Needs
Child's Date of Birth
/
Month
/
Day
Year
Date Picker Icon
Child's Grade
Child's Name
First Name
Last Name
Click all that apply
Allergies
Special Needs
Child's Date of Birth
/
Month
/
Day
Year
Date Picker Icon
Child's Grade
Comments
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