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Mobile Phone
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Birthdate
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1900
Birthdate cannot be a future date.
Gender
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Female
Address
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HI
ID
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IN
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KS
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ME
MH
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Are you active military?
No
Yes
Has any of your information changed?
No
Yes
What family members from your household are attending today?
Please list the names, first and last, of your household family members attending with you today.
What service are you attending today?
8:15 am
9:30am
11:00 am
6:45 pm
What service are you attending today? is required.
Where are you are attending today?
Shiloh Campus
Online
Where are you are attending today? is required.
Attendance History:
1st Time Guest
2nd Time Guest
3rd Time Guest
First Time Filling Out Connect Card
Regular Attender
Member
Attendance History: is required.
I would like to receive information about:
Becoming a Christian
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Prayer Request:
Is your prayer request Confidential?
No
Yes
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