Page 55 | The Dwelling Assembly of God

Name (Required)

Email Address (Required)

We would love to get to know you!

What is your Name & Spouse's Name (if applicable)?

What is your address?

Age Group:

Under 20

20's

30's

40's

50+

Do you have children?

List any children with names and ages below!

Today I Have Decided To:

Commit my life to following Jesus for the first time

Be baptized

Renew my commitment to Christ

Volunteer - Have someone contact me

I Would Like More Information About....

Water Baptism

Baby Dedication

Men's Ministry

Women's Ministry

Fellowship Groups

Young Adults

Children's Ministry

Membership Class

Other

Prayer Request, Praise Report or Comments

Would you like this prayer request, praise report or comment kept confidential for staff only?

Solve 3 + 5 = ?

The Dwelling Assembly of God