联系表格 Get Connected Form
请填妥表格后点击“Submit"。Please fill out this form and click submit.
日期 Date
*
回应 Response
请在适当的格子里打勾 Tick appropriately
*
Please select all that apply.
救恩 Salvation
再委身 Rededication
找寻教会 Seeking Home Church
访客 Visitor
您的个人资料 Your Particulars
英文姓名 Full Name (身份证 /护照所显示 As per NRIC/ Passport)
*
中文姓名
*
性别 Gender
*
Please select one option.
男 Male
女 Female
婚姻状况 Marital Status
Please select one option.
单身 Single
已订婚 Engaged
已婚 Married
离婚 Divorced
丧偶 Widowed
分居 Separated
Select Option
单身 Single
已订婚 Engaged
已婚 Married
离婚 Divorced
丧偶 Widowed
分居 Separated
年龄层 Age
*
Please select one option.
12 & below
13- 18
19- 35
36- 50
51- 65
66 & above
Select Option
12 & below
13- 18
19- 35
36- 50
51- 65
66 & above
手机联络号码 Mobilephone Contact No.
*
电邮地址 Email
This address will receive a confirmation email
住址 Address
--
Singapore
职业 Occupation
交流语言 Language Spoken
*
Please select all that apply.
英语 English
华语 Mandarin
福建 Hokkien
出席的会所 LE Centre
*
Please select one option.
淡滨尼会所 LE Tampines
兀兰会所 LE Woodlands
关爱小组 Cell Group
出席的聚会 LE Service
Please select one option.
主日上午9点聚会 Sunday 9am Service
主日上午11点30分聚会 Sunday 11.30am Service
神迹布道会 Miracle Service
青少年英语聚会 Speedlight Service (Youth)
其它 Others (Please specify in remarks)
备注 Remarks
呈交此表格表示我同意灯塔教会与我保持联系时可收集、使用和透露我的个人资料。
By submitting this form, I give consent to Lighthouse Evangelism to collect, use and disclose my personal data for purposes of facilitating and communicating with me.
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请填妥表格后点击“Submit"。Please fill out this form and click submit.
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