Pastoral Care Card

First Name

Last Name

Gender
Male
Female

Status
Married
Single

Date of Birth

Country

City

State

Previous Address

Spouse's Name ( if applicable )

Spouse's Date of Birth

My Decision Today
I am committing my life to Christ.
I am recommitting my life to Jesus.
I want to be Water Baptized.
I would like someone from the pastoral team to reach out to me.

We’d be honored to pray for you. Write down anything you need prayer for and our team will pray for you this week.

Confidential
Yes
No