CIOMinistries Connection Card

1

Welcome! Are you a first time visitor?/ Bienvenu(e)! Celle- ci est-elle votre premiere visite?* This field is required.Oui Non

YESNO

2

What is your name?/ Quel est votre nom?* This field is required.

3

Email* This field is required.

example@example.com

4

Phone Number / Numéro de téléphone

Please enter a valid phone number.

5

Questions, Comments, Prayer request? * This field is required.