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Response Card
Sunday, June 19th Response Card
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* Indicates required question
Name
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Phone
*
Your answer
Email
*
Your answer
Spouse's Name
Your answer
Spouse's Birthdate
MM
/
DD
/
YYYY
Spouse's Phone
Your answer
Spouse's Email
Your answer
Address
Your answer
Children's Names and Birthdates
Your answer
First Time Guest?
*
Yes
No
Active Military?
*
Yes
No
Do you believe in Jesus?
Yes
No
Clear selection
Have you accepted the free gift of Salvation?
Yes
No
Clear selection
Are you on the shore watching grace go by, choosing to not get in the boat that represents faith in Christ?
Yes
No
Clear selection
Do you want to be a son or daughter of King Jesus and make him Lord over your life?
Yes
No
Clear selection
How Do You Need to Respond to the Preached Word?
Your answer
Do you have any prayer needs today?
Your answer
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