Name*
Address
City
Phone*
Cell Phone

E-mail Address

            * Required fields

            Which ministries do you think would be most helpful?

             Check all that apply.

     Adult Ministries

    Sunday School Classes/Bible Studies      Men's Fellowship

    Lydia's Circle (Women's Fellowship)         Single Adults    

    MOPS (Mothers of Preschoolers)               College Ministry   

    Golden Agers/Senior Adults                      

    GROW Church Outreach Program   

       

     Teen/Middle School Ministries    

    Xtreme Life           Mission Trips    Summer Camp

    Arkansas Youth Conference

 

     Children's Ministries

    AWANA           Vaction Bible School          Upwards Sports    

    Fall Fest          Preschool Programs

 

     Music

    Adult Choir     Instrumental Ensemble

    Teen Choir     Junior Choir      Preschool Choir

 

     Counseling Services

    Divorce Care  Alcoholics Anonymous    Pre-marital Counseling

    Individual Counseling Services

 

 

 

  Are they currently attending any church?

Yes No

  Are they members at any church?

Yes No

            Have they recently moved into the area?

                    Yes No           

           If they have any children, please list their names and ages.

            Please list any additional information which will help us

            direct them to the area that most meets their needs.

Optional Information

Your Name
Your Phone
Relation to person(s) listed above