Online Connection Card
Welcome to Mercy City Church! We are so happy that you've connected with us! Please fill out this form so we can learn a little bit more about you.
Yes to Jesus
*
Please select all that apply.
Today, I'm committing my life to follow Jesus
Today, I'm renewing my walk with Jesus
New Here?
*
Please select all that apply.
1st Time Guest
Returning Guest
Updating my information
Name
*
Address
*
--
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Phone
*
Birthdate
*
Email
*
This address will receive a confirmation email
Marital Status
*
Please select one option.
Married
Single
Other
How did you get connected to Mercy City?
*
I'd like to learn more about:
*
Please select all that apply.
Connect Track
City Groups
Youth
Baptism
1 on 1 Ministry
Foundations Class
College and Young Adult
Where did you join us?
*
Please select one option.
Online
Lincoln Campus
Seward Campus
How many people joined you today?
Submit
Description
Welcome to Mercy City Church! We are so happy that you've connected with us! Please fill out this form so we can learn a little bit more about you.
×
Please Fix the Following