Guest Response Form
Date of Wilshire Visit
*
-
Month
-
Day
Year
Date
I would like to: (check all that apply)
Sign in as a guest
Join the church professing faith in Jesus Christ as Savior and request baptism
Join the church as someone already baptized
Speak with a minister
Request more information about Wilshire
Update my address, phone and/or email
Other
Today I attended (check all that apply):
Worship 9:00 am
Worship 11:00 am
Livestream
Sunday School
Wednesday activities
Special service
Other
Which specific class, activity or service did you attend?
Are you looking for a new church home?
Yes
No
Maybe
Current or previous church
If joining Wilshire, please list the last church where you were a member.
Adult 1
First Name
Last Name
Adult 2 (if any) at same address
First Name
Last Name
Date of Birth (Adult 1)
-
Month
-
Day
Year
Date
Date of Birth (Adult 2)
-
Month
-
Day
Year
Date
Email (Adult 1)
example@example.com
Email (Adult 2)
example@example.com
Phone Number (Adult 1)
Please enter a valid phone number.
Format: (000) 000-0000.
Phone Number (Adult 2)
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Marital Status
Single
Married
Divorced
Widowed
Partnered
Other
Do you have children visiting also? List their names and full birthdates below:
How did you hear about Wilshire?
Internet search
Website / YouTube
Family member
Friend
Recommendation from previous pastor/church
Drove by
Other
Other Info/Comments?
Submit
Should be Empty: