The WORD Christian Center

Operation 365 - Salvation Information Form (Final)

Page 1page 1 of 1

First Name Last Name
Address
Address Line 2
City State Zip Code
Phone Number
Phone Number
Email Address
Select all that apply
Salvation
Re-dedication
Infilling of the Holy Spirit
Select all that apply
Friend
Family Member
Co-Worker
Other

First Name Last Name
Phone Number
Email Address
* required