You can always press Enter⏎ to continue
You are very important to us!
Please take 1 minute to submit this form so we can know how to best serve you.
7
Questions
START
1
Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
Email
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
3
How may we help you?
*
This field is required.
Check all that may apply!
I'm visiting for the first, second, or third time
I want to become a member of New Vision
I want to give my life to Jesus
I want to rededicate my life to Jesus
I want to be baptized
I want more information about your ministry
Previous
Next
Submit
Press
Enter
4
If you are a visitor, what is the date of your visit?
Or date of broadcast (if watching online)
-
Date
Month
Day
Year
Previous
Next
Submit
Press
Enter
5
Do you have additional comments or prayer requests?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
6
What is the best phone number to reach you?
Area Code
Phone Number
Previous
Next
Submit
Press
Enter
7
Can we text you?
Yes
No
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
7
See All
Go Back
Submit