Connect Form

We would love the opportunity to get to know you better and help you connect and grow with us!

Contact

✕

First Name

Last Name

Email Address

Phone Number

Date of birth

Address

Apartment, suite, etc.

City

State

Postal / Zip Code

Gender

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I would like to learn more about... (Please select all that apply)

Becoming a Follower of Jesus

Growing as a Follower of Jesus

Baptism

Volunteering

Joining an Inspiration House

Leading or Hosting an Inspiration House

Infant/Child Dedication

Membership

Are you married?

Contact

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First Name

Last Name

Email

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*If married, please select add another contact and enter your spouses contact info.

Do you have children?

Contact

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First Name

Last Name

Email

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Comments / Questions / Prayer Requests