First Name

Last Name

Country

City

State

Email - Primary

Cell number - Primary

Cell carriers (to receive East Grand texts) (e.g. Sprint, Verizon, etc.)

Please list each family member's name, gender, birthday, baptism date, anniversary date, school grade (if applicable)

Interest
I'm a first-time guest
I have attended several times
I am interested in learning more about East Grand and meeting the ministers and shepherds
I am interested in placing membership
I am interested in studying the Bible with someone