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Name(s)

Date

Phone

This Is My...

Email

Address 1

Address 2

Country

City

State

Zip/Postal Code

Date of Birth

How Did You Hear About Us?

WHAT'S YOUR NEXT STEP?

First Steps
Receive(d) Jesus as Lord and Savior of my life
Interested in Baptism
Want to meet with a pastor or staff member
Interested in a discipleship relationship

Second Steps
I want to know more about Community Groups
Sign me up for the next GCC 101
I'm interested in serving

Comments / Prayer Requests

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WHAT'S YOUR NEXT STEP?

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