Covenant Class Questionnaire

First Name

Last Name

Email

Phone Number

Address

Apartment, suite, etc.

City

State

Postal / Zip Code

Tell us how you came to Christ.

Were you baptized by immersion? If so, when?

How can we pray for you?

Would You Like To Transfer Membership From Another Church? (Not Required)

Yes

No

Former Church Name

Church Street Address

Church Phone Number

Church Web Address