On Ramp Connection Card

Name *

First Name

Last Name

Birthday *

MM

DD

YYYY

Date *

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Single

Married

Divorced

Widowed

Spouse's Name

First Name

Last Name

Birthday

MM

DD

YYYY

Anniversary

MM

DD

YYYY

Are you Baptized? *

Yes

No

Are you Interested in being Baptized?

Yes

No

Baby Dedication?

Yes

No