App Connection Card

Connection Card
Today's Date

Month Day Year
Date
Select Campus *
Please indicate which service

Saturday 6pm Sunday 9:15am Sunday 11:00am Online Campus
I am a(n)... *

1st Time Visitor 2nd Time Visitor Attendee Member
Looking for a church home

Yes No
I am...

interested in baptism (see Next Steps form) interested in joining a Group (see Next Steps form)
I would like to request

a hospital visit.
Those In attendance today: *

First Name Last Name
Adult Child
Date of Birth

Month Day Year
First Name Last Name
Adult Child
Date of Birth

Month Day Year
First Name Last Name
Adult Child
Date of Birth

Month Day Year
First Name Last Name
Adult Child
Date of Birth

Month Day Year
Please fill out the following:
Married Divorced Widowed Never Been Married
Address

Street Address

City State / Province

Postal / Zip Code
Phone Number
E-mail
How did you hear about Mount Pleasant?
Should be Empty:

Connection Card