Connection Card
Let us know you're here, we are happy to serve you. If you are already a member, contact us at info@churchatthemill.com.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Email Address
*
Your Date of Birth
-
Month
-
Day
Year
Date
Which congregation did you visit?
*
Central (Moore)
Woodruff
Marital Status
Single
Married
Spouse's Name
First Name
Last Name
Spouse's Phone Number
-
Area Code
Phone Number
Spouse's Email Address
example@example.com
Your Spouses Date of Birth
-
Month
-
Day
Year
Date
Which service do you attend?
9:00 AM
Online
11:00 AM
Your Attendance at Church at The Mill
*
First Visit
Attend Regularly
Second Visit
I am a Member
Third Visit
How did you hear about us?
Internet Search
Facebook
Instagram
Friend/Family invited me
Drove by
Fill out below if you have children.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child #1
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Grade
School
Gender
Special Needs/Allergies
Child #2 (If applicable)
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Grade
School
Gender
Special Needs/ Allergies
Child #3 (if applicable)
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Grade
School
Gender
Special Needs/ Allergies
If you have another child, please enter all info here.
If not English, what is the primary language spoken in the home?
I give permission for my children to be photographed for media.
*
Yes
No
Submit
Should be Empty: