Date (required) Suffix (required) ---Mr.Mrs.Miss.Ms. Your Name (required) Birth Date Your Email (required) Address Home Phone # Cell Phone # Work Phone # I am... ---SingleMarriedDivorcedWidowedSingle Parent Service attended? ---Sunday Bible Study 9:30amSunday Worship 10:45amWednesday Prayer 6:30pmOther If Other, when? Would you consider contact by... ---PhoneMailEmailIn Person I am visiting as a guest of... Are you interested in becoming a member of Southside Baptist Church? ---YESNOUNDECIDED Would you be interested in joining a Sunday morning Bible Study? ---YESNOUNDECIDED Are you a member of a church? ---YESNO If YES, Where
Date (required)
Suffix (required) ---Mr.Mrs.Miss.Ms.
Your Name (required)
Birth Date
Your Email (required)
Address
Home Phone #
Cell Phone #
Work Phone #
I am... ---SingleMarriedDivorcedWidowedSingle Parent
Service attended? ---Sunday Bible Study 9:30amSunday Worship 10:45amWednesday Prayer 6:30pmOther
If Other, when?
Would you consider contact by... ---PhoneMailEmailIn Person
I am visiting as a guest of...
Are you interested in becoming a member of Southside Baptist Church? ---YESNOUNDECIDED
Would you be interested in joining a Sunday morning Bible Study? ---YESNOUNDECIDED
Are you a member of a church? ---YESNO
If YES, Where
