Northpark - Connect Form

Connect Form

First Name

Last Name

Email

Phone Number

Date of birth

Address

Apartment, suite, etc.

City

State

Postal / Zip Code

Gender

Marital Status

Children's Names, Ages, Grades:

Please Check All That Apply:

I am a first time guest.

I am updating my information.

I would like for a minister to contact me.

I would like to commit my life to Jesus.

I would like to be baptized.

I am praying about joining the church.

I would like to join the church by statement of my faith & baptism.

I would like to join the church by transfer from another church.

Former Church's Name & City (if transferring from another church):

I would like more info on the following ministries:

How can we pray for you:

About my prayer request: