Guest Response Form

Guest Response Form
Date of Wilshire Visit*

MonthDayYear
Date
I would like to: (check all that apply)

Sign in as a guestJoin the church professing faith in Jesus Christ as Savior and request baptismJoin the church as someone already baptizedSpeak with a ministerRequest more information about WilshireUpdate my address, phone and/or emailOther
Today I attended (check all that apply):

Worship (in person)LivestreamSunday SchoolWednesday activitiesSpecial serviceOther
Which specific class, activity or service did you attend?
Are you looking for a new church home?

YesNoMaybe
Current or previous church
If joining Wilshire, please list the last church where you were a member.
Adult 1

First NameLast Name
Adult 2 (if any) at same address

First NameLast Name
Date of Birth (Adult 1)

MonthDayYear
Date
Date of Birth (Adult 2)

MonthDayYear
Date
Email (Adult 1)
example@example.com
Email (Adult 2)
example@example.com
Phone Number (Adult 1)
Please enter a valid phone number.
Phone Number (Adult 2)
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Marital Status

SingleMarriedDivorcedWidowedPartneredOther
Do you have children visiting also? List their names and full birthdates below:
How did you hear about Wilshire?

Internet searchWebsite / YouTubeFamily memberFriendRecommendation from previous pastor/churchDrove byOther
Other Info/Comments?
Should be Empty: