Church Contact Form

Church contact form

Please pass on your details to us, so we can look out for you on your next visit. If you have any questions ahead of your visit, please call us.

Church Office: 01874-610319
Robert Jones Mobile: 07779 513725
Email: rob@breconelim.co.uk

* Indicates required field

Your Name *

First

Last

Email *

Phone Number *

Planning to attend on date *

Please tell us which day to look out for you in Church i.e. 'Sunday 18th May 2014'

Reason for your visit *

Moved to the area On holiday Just looking Prefer not to say

How did you hear about our Church? *

Internet Search Friend Other

What is your age? *

Less than 13 13-18 19-25 26-35 36-50 Over 50 Prefer not to say

Tell me more about one of the groups below (optional) *

Church / God / Elim Junior Church Youth Church Music Group

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