ARE YOU WITH US Survey

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* 1. Please tell us about yourself!

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. MY PERSONAL INFORMATION

IS CURRENT AND LISTED ABOVE

NEEDS TO BE UPDATED, AND IS LISTED ABOVE.

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* 3. We have the following minors in our family

TEENS: 12-17 years old

CHILDREN: 11 and below

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* 4. HOW MANY CHILDREN?

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* 5. HOW MANY TEENS?

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* 6. I AM...

A MEMBER... I have officially joined and am committed to attendance, service, and stewardship. I am also eligible to be a voting member of this church with its rights and privileges.

An E-MEMBER... I have officially joined and commit to stay connected through online worship, program support, discipleship, and stewardship.

A PARTNER...Not joined but connected; I believe in and support the vision. I am willing to serve and invest as I am able.

A FORMER MEMBER.... Please remove me from your database.

INTERESTED IN BECOMING A MEMBER...

NONE OF THE ABOVE.