INTERNAL USE ONLY
RESPONSE
Encourager
First Name
Last Name
Phone
*
Email
*
Date of birth
Gender
Male
Female
SALVATION
Did you trust Jesus for Salvation TODAY?
Yes
No
Have you ever made a decision like this before?
Yes
No
Please describe when this occurred and why you feel the need to respond again?
BAPTISM
When did you give your life to Jesus, trusting Him alone as your Savior and Lord?
Have you ever been baptized before?
Yes
No
Was it before or after your salvation? Explain
REPENTANCE & PRAYER
If you were saved before, are there some specific things in your life that you need to repent or turn away from?
Yes
No
Please describe these areas and how our team can pray for you?
Encourager Notes
Submit