Connection Form

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Full Name

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Email

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This address will receive a confirmation email

Phone

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Address

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Other Household members and relationships

Okay to publish to Church Body?

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Please select one option.

Yes No Option

I have made the decision to follow Jesus and would like to speak to someone about it.

Please select one option.

Yes

I am ready to connect and would like to talk to someone about it.

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Yes

I am interested in serving at Illuminate in the area(s) of_____.

Comments or Prayer Requests

Please make a donation in my/our name to:

Please select one option.

Food Pantry Matthew's House River's Edge Drop-In Center IM Kids RAVE

Date

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Description

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