1. How many people are worshiping with you? (not including you)(required)

2. Please list others worshiping with you

3. I am a:

4. Contact Information

Your Name (required)

Address

City, State, Zip:

Your Email(required)

Your Phone

5. Change in contact information?
YesNo

6. Your age group:(required)

7. Birthday

8. How did you hear about BMZ Church?

9. I will invite a friend to join us online.
YesNo

10. My next step today is
I will read the scripture for this weekStart a Bible Reading ProgramAccept Jesus as my Savior for the first time

Other

11. I want more information about
Becoming a follower of JesusClassesServing at BMZ Church

Other

12. Please include prayer request on the BMZ public prayer list

YesNo

My comments/prayer request

13. Thank you for worshiping with us and taking time to fill out the online connection card. Will you be plan to join us next week?
YesProbablyDefinitely!MaybeNo