Connection Card

Contact Information First Name Last Name Address Apt / Suite / Other City State Postal/Zip Code Country Primary Phone Number Email Address

Personal and Family Information Gender

Male Female

Age Group Marital Status List the name and age of any child in your family

Connection Information Do you attend Church of the Highlands?

First Visit Second Visit Third Visit Attend Regularly

Connection Status

Check all that apply. I am a member I would like to join Church of the Highlands I am interested in a small group

How did you hear about Church of the Highlands?

Spiritual Response My decision today

Check all that apply. I am committing my life to Christ. I am renewing my commitment to Christ.

Prayer Request Type

For Prayer Team Confidential

Prayer Request