Name *

First Name

Last Name

Relationship *

Attending for the First-Time

Attender

Member

Phone

(###)

###

####

Please contact me with information about:

CCMV Beliefs and Core Values

Children's Classes and Activities

Student Groups and Activities

College Age Groups and Activities

Adult Groups and Activities

Senior Adult Groups and Activities

Opportunities for Serving

Baptism

Membership

Other (please specify in the Other Memo section below)

Do you want the church to publish this request on the weekly prayer sheet?

Yes, please include this request on the weekly prayer sheet

No, thank you. Please keep this confidential among the church leaders.