Connect Card

Your name *

Last name

Email address *

Phone Number *

Phone type

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Address *

HomeWorkOther

Country

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Street Address

Apt/unit/box (optional)

City

State

Postal code

I am a North Strand Community Home Guest. *

Yes

No

Birthday *

Gender *

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Marital Status

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I accepted Jesus Christ Today

I recommitted my life to Christ Today

I am interested in your next Partnership Class

I would like to be baptized

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