Online Connection Card

Please fill out this form and click submit.

We're glad to have the opportunity to grow in Christ together today!

Please take a moment to fill out the information below.
And select "Submit" to complete the Online Connection Card.

Your Information

An email or phone # helps us to respond to you but is not required

Name

*

Email

Phone

Address

Let Us Know-

I am a ....

*

Please select all that apply.

First Time Visitor Regular Attender Neither

I attended ...

*

Please select one option.

1st service (8:30 am) 2nd service (10:30 am) I have not attended a Sunday Service

Today I have decided to:

Please select one option.

Receive Jesus Christ as my Lord Renew my commitment to Christ Other - Let us know in the Notes Section below

I would like to know more about...

Please select one option.

Becoming a Christian Growing in my faith Baptism Becoming a member of JCC Dedicating my child Other - Let us know in the Notes Section Below

Prayer Requests, Message to the Staff and other Notes

*

Prayer/Message Options

Please select one option.

Please keep this information confidential ( Pastors Only ) Share this with the prayer team I would like to talk to a pastor

Description

Please fill out this form and click submit.

Please Fix the Following

Close