House Church Registration

We are so excited that you are interested in one of our House Churches! Please fill out this form and we will respond with all the info you need.

Name

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Email

*

This address will receive a confirmation email

Mobile Phone

*

Address

*

How long have you attended Antioch Wichita?

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Please select one option.

Have not attended yet Less than 6 months Between 6 months and 2 years More than 2 years

Have you attended one of our House Churches in the past?

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Please select one option.

Yes No

A little about you: This helps us suggest an appropriate House Church for you.

About you:

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Please select one option.

Married Adult Single Adult College Student

Age:

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Please select one option.

20's 30's 40's 50's 60's

How many children under 18 do you have? (If none, please write "none")

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Age of Children (Check all that apply)

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Please select all that apply.

None Birth-Toddler Pre-K - Kindergarten 1st - 5th Grade 6th - 8th Grade 9th - 12th Grade

What part of town do you live in?

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Please select all that apply.

Cental/Downtown West East North South Valley Center Goddard/Maize Derby/Haysville Andover/Augusta Other

Description

We are so excited that you are interested in one of our House Churches! Please fill out this form and we will respond with all the info you need.

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