Online Visitor Card

Name *

First Name

Last Name

Primary Phone *

(###)

###

####

Other Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I / we would like... (Please choose all that apply)

A followup phone call

A Pastoral home visit

To be added to our email / text messages for events and weather related announcements

Are you presently interested in learning about membership at Covenant Presbyterian Church?

Yes

No

Perhaps later