CONNECT CARD - Life Impact Church Regina

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Connect Card

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Name *

Phone:

Email:

Address:

Address Line 1

City

State / Province / Region

Postal Code

I am a:

My next step today is to:

How did you hear about us?

(Name of person who invited you, postcard, mailer, doorhanger, social media)

Custom Captcha *

What is 1+1?

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