I'm New

Connection Card

Let us know you're here, we are happy to serve you. If you are already a member, contact us at info@churchatthemill.com.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *
Email Address *
Marital Status

Single Married
Spouse's Name

First Name Last Name
Spouse's Phone Number

Area Code Phone Number
Spouse's Email Address
example@example.com
Which service do you attend?

Outdoor Online
Your Attendance at Church at The Mill *

First Visit Attend Regularly Second Visit I am a Member Third Visit
Your Date of Birth

Month Day Year
Date
Your Spouses Date of Birth

Month Day Year
Date
Fill out below if you have children.
Name

First Name Last Name
Birthdate

Month Day Year
Date
Grade
School
Gender
Special Needs/Allergies
Child #2 (If applicable)

First Name Last Name
Birthdate

Month Day Year
Date
Grade
School
Gender
Special Needs/ Allergies
Child #3 (if applicable)

First Name Last Name
Birthdate

Month Day Year
Date
Grade
School
Gender
Special Needs/ Allergies
If you have another child, please enter all info here.
Should be Empty:

Connection Card