VISITOR CONTACT INFORMATION

Fill out the form below to let us know more about you.

Name(s)

Primary Email

Phone(s)

Additional Email

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Children Living at Home (Name + Age)

Your Age Group?

18-23

24-29

30-39

40-49

50-59

60-69

70-up

How Did You Learn of Our Church?

Mailer

Relative

Friend

Other

What Would You Like Information On?

Salvation & Baptism

Adult Bible Studies

Children's Minsitries

Youth/Student Ministries

Music Ministry

Mission Opportunities

Thanks for submitting your information!

Physical Address:
12568 Philadelphia Church Rd
Stanfield, NC 28163

Mailing Address:
P.O. Box 280
Stanfield, NC 28163

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