EMBC Visitors' form

EMBC Visitors' form
Greetings, and thank you for taking time to fellowship at Ebenezer Missionary Baptist Church (EMBC)!

If you attended one of our morning worship services or a special event/service and did not submit a completed visitors' form, please take a few minutes to complete and submit our online visitors' form. We would like to follow up with you in the near future, and we will use this form to contact you based on whatever optional contact information you share.

--Rev. Dr. Cornelius E. Battle, Sr., Pastor of EMBC
What is your name?*

PrefixFirst NameMiddle NameLast NameSuffix
E-mail address (optional; please use personal address if possible)
Mobile number (optional)
Home phone number (optional)
Address (optional)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of your visit*

MonthDayYear
Was this your first visit to EMBC?*
If you have visited EMBC before, how many times have you visited before this last visit? (optional)
How did you learn about EMBC? (check all that apply)*

It showed up in an Internet search of area churchesWord of mouthRadio/newspaperSomeone invited meHave driven by the churchHeard of or met Dr. Battle outside of his role as Pastor of EMBCSaw the church's name/website on a paper event flyerSaw an event flyer on the Internet with the church's name/websiteSaw/"Liked" the church's Facebook PageSaw/"Followed" the church's Twitter feedOther
What is your age range?*
Do you have a spouse?*
Do you have any children?*
Do you have at least one child under the age of 18?*
Are you currently a college or university student?*
Why did you decide to visit EMBC? (check all that apply)*

Someone invited me (please share below)I would like to learn about being a follower of ChristI would like accept the gift of salvation and then get baptisedI am looking for a home churchI would like to unite with this churchI would like to learn more about this church's ministriesI would like to get more information about this church's Cub/Boy/Girl Scout troopsI would like to get spiritual counseling from Pastor BattleI would like to obtain prayer for/about somethingOther (please explain below)
I was invited by:

PrefixFirst NameLast NameSuffix
Other reason for visiting EMBC:
Are you a member of a church?
Should be Empty: