PRINT THIS PAGE

PLEASE PRINT THIS PAGE, FILL IT OUT, AND MAIL IT TO PASTOR KIRBY AT
6868 NORTH SOCRUM LOOP ROAD, LAKELAND, FL  33809


 

FULL NAME: ________________________________________________


STREET ADDRESS: __________________________________________


CITY: _____________________


STATE: ____________________


COUNTRY: ______________________


ZIP CODE; __________________


EMAIL ADDRESS: __________________________________



Please give us your spiritual relationship with Christ and your personal Christian testimony.


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________


_____________________________________________________________