Name *

First Name

Last Name

Are you?

Male

Female

Married

Single

Engaged

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Have you been to Church On The Move before?

Yes

No

How did you hear about Church On The Move?

Website

Social Media

Someone Invited Me

Other

MY DECISION TODAY:

I am committing my life to Christ

I am renewing my commitment to Christ

I want to be baptized

I would like to talk with a ministry team member

TELL ME MORE ABOUT

Joining the church

Small Groups

Growth Track

Serving opportunities

IS YOUR PRAYER REQUEST

For Prayer Team

Confidential