Connection Card

We'd love to get to know you! Share about your experience, update your information, or just let us know how we can be a part of your journey of faith.

Name: Name: First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Home Phone Home Phone - ### - ### ####
Cell Phone Cell Phone - ### - ### ####
Date of Birth Date of Birth / MM / DD YYYY
Your Family (list names and ages here):
Which Crossroads Campus do you attend?

Which Crossroads Campus do you attend? Vancouver, WA (7708 NE 78th Street) Online Campus
Today I:

Today I: Attended Crossroads for the first time Prayed to receive Jesus for the first time Rededicated my life to Jesus Christ Would like to update my info
I would like more information about:

I would like more information about: Being a Christian and walking with Jesus Getting connected to the ministries at Crossroads (feel free to list ministries in the Prayer and Addl. Info section below) Getting connected to a community group Starting a group or weekly gathering in my home
How did you hear about Crossroads?

How did you hear about Crossroads? Internet Campus Friend or Family Jesus is Real Radio/TV Social Media Print Advertisement Other (let us know!): Other (let us know!):
I am interested in:

I am interested in: Getting connected to Ministries at Crossroads Volunteering at Crossroads Being a Church Online Host Sharing how Church Online has positively impacted me Other Other
Additional Information:
Please do not contact me with important text message updates.