FBCH Connection Form

FBC Holland Connection Card

All fields with an "*" are required, other fields are not required to fill out.
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Age category*

0-10 years11-18 years18-25 years26-40 years41-60 yearsOver 60 years
Do you have Children under 18?*

YesNo

Would you like to receive our monthly newsletter on email?*

YesNo
In response to the gospel message, would you like someone to contact you?

Yes
Would you like to be contacted about Baptism?

Yes
Are interested in learning about Membership at FBC Holland?

Yes
Would you like someone to contact you about Membership at FBC Holland?

YesNo
Do you have a prayer request?

Yes
Please add your prayer request here:
Are you interested in more information about our (check all that apply):

Women's GroupMen's GroupSmall Groups in Host HomesChildren's Group (enrolled PreK-5th Grades)Youth Group (6th-12th Grades)
A team leader from that group will be in contact with you in the next week.

Thank you for your interest in this area of ministry!
What areas are you interested in serving as a volunteer? Note: All serving areas with Kids or Youth require FBCH Membership, Background Check and Training.*

Children's MinistryYouth MinistryNurseryKitchen TeamHospitality TeamGreeting TeamTechnologyWorship MusicFollow Up TeamSmall Group Host HomeBuilding and Grounds TeamFood PantryBackpack MinistryNone at this time
Should be Empty:

FBC Holland Connection Card