CONNECT Form • Living Waters Christian Centre

GET CONNECTED

Your Details

Title *

Mr

Mrs

Miss

Ms

Other

First Name *

Last Name *

Home Address

Home Address Line 2

Home City

Home Postcode

Email Address

Home Phone

Mobile Number

Date of Birth

Gender

I AM...(Tick all that apply)

Searching for God

Just visiting, please keep me in the loop

Looking for a church home

Wanting to become a member of LWCC

Wanting a tithe number

Spouse / Partner Details

Please include Full Name, Email, Phone, Date of Birth

Spouse / Partner Details

Children(s) Details

Please include Children's Full Names, Dates of Birth, and Gender.

Children's Details

Thanks so much for the Info!