MRBC Connection Card

How are you attending our service:

On-Campus

On-Line

Name *

First Name

Last Name

Birthdate Date

MM

DD

YYYY

Phone

(###)

###

####

Are you currently attending a church

Yes

No

Spouse Name

First Name

Last Name

Spouse Birthdate

MM

DD

YYYY

My Next Steps: (Check All That Apply)

I prayed and asked Jesus into my life today

I am renewing my relationship with Jesus today

I am interested in being baptized

I am interested in joining this church

I would like a visit from a minister or deacon

My Visit Today:

1st Time Guest

2nd Time Guest

3rd Time Guest

Member/Regular Attender

Child 1 Name

First Name

Last Name

Child 1 Birthdate Date

MM

DD

YYYY

Child 2 Name

First Name

Last Name

Child 2 Birthdate Date

MM

DD

YYYY

Child 3 Name

First Name

Last Name

Child 3 Birthdate Date

MM

DD

YYYY

I would like more information on: (Check All That Apply)

Hope's Table

MRBC Kids

MRBC Students

MRBC Young Adults

Grow Groups

Discovering MRBC Class

I would like to know more about a personal relationship with Jesus