Crossroads Wesleyan Church

Connection Card

Welcome to our church! We're glad you're here. Our team would love to serve you and help you get connected.

First Name

Last Name

Email

Phone

Address 1

Address 2

Country

City

State

Zip/Postal Code

How many times have you visited our church?
This is my first time
A few times
Regular attender

Age Group

Marital Status

I would like to learn more about (check all that apply):
Baptism
Volunteering
Membership
Community Groups
How to commit my life to Christ

My Decision Today
I'm Committing my life to Christ for the first time
I'm renewing my Commitment to Christ
I want to be baptized

Prayer Requests:

For Prayer Team
Confidential

Anything else you'd like to share?