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Contact Info

Name:  -Mr.Mrs.Miss
Street Address:    Apt #:   City:  
State:   Zip:
Home Phone:   Work Phone:   Mobile Phone:  
Email Address: 

 Mail Preferences

Would you like to receive our bi-monthly calendar by mail?  --YesNo
Would you like to receive our weekly events email?    --YesNo

Optional Info

Names of Children                   Age
 
 
   
 
   

 Vocation:   Birth Date  (mm/dd/yyyy):

How did you find out about the Vineyard?  --Coffee ConnectionFamilyFriendLocationPrevious VineyardWebsiteYellow PagesOther Other: 

Marital Status: --SingleMarriedDivorcedWidow(er) Anniversary if married (mm/dd/yyyy):

I am interested in:
knowing more about how to begin a relationship with Jesus
being baptized
attending the next Getting Planted class and meal hosted by the pastors.
other  

Comments: 

Thank you for your time.