Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Spouses Name

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Children living at home *

Yes

No

Have you attended CTM before? *

Yes

No

What decision did you make today?

I knew I needed to be forgiven and today I started a relationship with God.

I knew I had made some choices that took me away from God's best, but today I came back to God.

I thought I had accepted Jesus in the past, but today I wanted to be sure.

I am interested in being water baptized.

I am ready to get involved in a House Church.