Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Mobile Phone

(###)

###

####

Please include my name(s) and Address in the CCV Directory *

Yes

No

I am new to the Lansing area

I am looking for a new church home

I want to commit my life to following Jesus

I'd like to attend a Newcomer's Informational Meeting

I'd like to join a midweek homegroup

I am visiting the Vineyard for the first time

I'd like more information about the Christian faith

I'd like more info about Capital City Vineyard Church

I'd like to receive a personal call from the Pastor

I would like more information about the:

Children's Ministry

Youth Ministry

Worship Ministry

Prayer Ministry

Technical Ministry

Small Group Ministry

Hospitality Ministry

Benevolence Ministry

Campus Ministry

Missions Ministry