WLA Connection Card

• • Your Name*
    First Name

    Last Name
  • Your E-mail*
     
  • Phone Number
     

    (###)

    -

    ###

    -

    ####
  • Address
    Street Address

    Address Line 2

    City

    Province / State / Region

    Postal Code / Zip

    Antigua and BarbudaBahamasBarbadosBelizeCanadaCosta RicaCubaDominicaDominican RepublicEl SalvadorGrenadaGuatemalaHaitiHondurasJamaicaMexicoNicaraguaPanamaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesTrinidad and TobagoUnited StatesArgentinaBoliviaBrazilChileColumbiaEcuadorGuyanaParaguayPeruSurinameUruguayVenezuelaAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyLatviaLiechtensteinLithuaniaLuxembourgMacedoniaMaltaMoldovaMonacoMontenegroNetherlandsNorwayPolandPortugalRomaniaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandUkraineUnited KingdomVatican CityAfghanistanBahrainBangladeshBhutanBrunei DarussalamMyanmarCambodiaChinaEast TimorIndiaIndonesiaIranIraqIsraelJapanJordanKazakhstanNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLebanonMalaysiaMaldivesMongoliaNepalOmanPakistanPhilippinesQatarRussiaSaudi ArabiaSingaporeSri LankaSyriaTaiwanTajikistanThailandTurkeyTurkmenistanUnited Arab EmiratesUzbekistanVietnamYemenAustraliaFijiKiribatiMarshall IslandsMicronesiaNauruNew ZealandPalauPapua New GuineaSamoaSolomon IslandsTongaTuvaluVanuatuAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral African RepublicChadComorosCongoDjiboutiEgyptEquatorial GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauCôte d\'IvoireKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTanzaniaTogoTunisiaUgandaZambiaZimbabwe

    Country
  • Can we add you to the WLA congregational email list? We send out emails weekly to update on events happening at the church, to share information from our staff and elders, etc.*
    Yes

    No
  • Date you attended WLA
    MM

    DD

    YYYY
  • Which service did you attend?
    >9:00AM11:00AM
  • How did you hear about WLA?
  • Please indicate which of the following programs would be of interest to you and/or your family and the respective leaders will be in touch soon.
    Please select all that apply.
    Children's Programs

    Youth Programs

    Young Adult Programs (18-25ish)

    Women's Ministry Programs

    Men's Ministry Programs

    Forevergreen Programs (Retirees)
  • I am interested in...
    Please select all that apply.
    Connection Lunch (a get-to-know-you event for newcomers)

    WLA 101 (an event to learn about the history of WLA and what we believe)

    Baptism Class

    Membership Class

    Giving to WLA

    RightNow Media Subscription (FREE)
  • Please let us know if there's anything else we can help you with.
  
  Submit