E-Connection Card

E-Connection Card
Memory Verse:

Matthew 28:20b
Complete this form to let us know that you are attending on line. It is also a great way to let us know if you are new, if you have a change of information or if you have a prayer request.
Select one (if applicable)

1st Time VisitorTraveling VisitorChange in Information
Service Attended:

8:009:1510:45Online
Marital Status

SingleMarriedWidowed
Spouse Name (if Married)
Name:
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone:

Area CodePhone Number
Name/ Age of children under 18
I want more information about:

Crossroads Christian ChurchWhat it means to be a ChristianRenewing my commitment to ChristBaptismBible Studies/Small GroupsStephen MinistryChildren's Activities (3 yrs - 5th grade)Youth Activities (Grades 6 - 12)
Comments/Prayer Request:
Share Prayer Request with Prayer Chain?

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Should be Empty: