Contact information

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Contact information

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First Name *

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Last Name *

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Name of spouse and/or kids living at home

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Email *

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Address

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Phone number

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Have you visited our church before? *

This is my first time

A few times

Regular attender

I would like to learn more about (Check all that apply)

Jesus

Baptism

Volunteering

Membership and/or The Wesleyan Church

I made a decision

I dedicated my life to Christ

I rededicated my life to Christ

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How did you hear about us?

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Prayer Request?

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