The Assembly West Monroe

Connect Card

Welcome to our Church! We're glad you're here. Our team would love to serve you and help you get Connected.

First Name

Last Name

Spouse Name

Last Name

Email

Phone

Address 1

Address 2

Country

City

State

Zip/Postal Code

How many times have you visited our church?
This is my first time
A few times
Regular attender

I would like to learn more about (check all that apply):
Baptism
Volunteering
Membership
Connect Groups
Discipleship

Did you make a decision of Salvation today?
Yes
No

How did you hear about us?

Anything else you'd like to share?

Watching online?
Attending the service in person?