Effingham Partners Retreat- June 30 (6-8:15pm) & July 1 (9-noon)

Biographical Information

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* 1. Contact Information

Name *

Street *

Mailing

City/Town *

State/Province *

ZIP/Postal Code *

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* 2. Preferred Phone

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* 3. Other Phone

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* 4. Preferred Email

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* 5. Gender

Male

Female

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* 6. Birthdate

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* 7. Marital Status

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* 8. Place of Employment

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* 9. Ethnicity

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* 10. Have you previously been baptized in a Christian Church?

Yes

No

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* 11. If so, what was the approximate date. (month and year)

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* 12. Are you transferring membership from another church?

Yes

No

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* 13. If so, which church will you be transferring from?

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* 14. City, State of Church you are transferring from

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* 15. For tax purposes would you like your tithes and contributions individual or combined (with your spouse)?

Individual

Combined

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* 16. Our next Partner Joining at the Effingham Campus is Sunday, August, 27 2017. Will you be attending a worship service that day?

Yes

No

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* 17. What Service will you be joining in that Sunday? (Please note this is for our Effingham Campus only)

9:00

10:30

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* 18. Are there any immediate family members living in your household? If you answer no to this question, you will have finished registering for the Next Steps Partnership Retreat.

Yes

No