Help us get to know you...

Date you joined us MM/DD/YYYY *
Title
 Dr.  
 Mr.  
 Mrs.  
 Ms.  
 Miss. 
Name *
Address if Changed (else put Same)
City
Prov/State
Postal/Zip
Email
Home Phone ###-###-####
Work Phone ###-###-####
I am
 a first time guest  
 a repeat guest  
 an attender  
 a partner 
Marital Status
 Single  
 Married  
 Other 
Birthday MM/DD/YYYY
Occupation
Number of Viewers *
My Decision Today
 I am commiting my life to Christ for the first time  
 I would like to speak to someone about my spiritual journey  
 I want to be baptized 
I'd like to receive information about the following
 Discovering Lakeside (pre-req for Partnership)  
 Discovering Your Gifts  
 Discovering Spiritual Maturity  
 How to join this church family  
 Child dedication  
 Newcomers to Lakeside Church  
 Marital and family counseling  
 Marriage preperation 
Comments, Requests or Prayer Needs for
 Community Care Ministry  
 Confidential (Pastoral Team only)  
 Prayer Team  
 I would like to talk to a Pastor  
 I would like to register for: 
Comments
Will you be inviting a friend or family to Lakeside Online
 Yes  
 No  
 Maybe 
Powered byEMF Free Form Builder
Report Abuse
This information is used only for the purpose of Lakeside Church