Connect With Us NameFirstLastDate*Which worship service did you attend?*8 am11 am7 pmAddress*City/State/Zip*Cell/Home Phone*Email Address*Please check your age group:Under 1212-1819-3031-50Over 50What is your marital status?SingleMarriedDivorcedWidowedHow did you hear about us?*Random VisitTV/RadioPersonal InvitationInternetSocial MediaAre you a new resident in Brevard County?*YesNoMy Decision Today:*To Accept Jesus As Lord & SaviorSchedule Me for Baptism 1st Sunday of Next MonthChurch MembershipI Would Like a Home VisitPlease Point Me in the Right Direction:BEST (Believers’ Enrichment Spiritual Training)Discipleship CourseMET (Ministers Enrichment Training)Driven Life GroupSendThis field should be left blank
