[text* last-name placeholder="Last Name"]
[text* first-name placeholder="First Name"]
[email* your-email placeholder="Email"]
[tel* your-phone placeholder="Phone"]
[select connection-checkboxes include_blank "I made the decision to follow Jesus" "I’m considering opening my life to Jesus" "I want to learn about becoming a member in Bible classes" "I want to belong to a small group" "I'm interested in resources to help me grow spiritually" "I want to be baptized" "I want to get involved at the church by serving" "I want to help share God's love in my community and/or around the world"]
[textarea your-message placeholder="Any prayer request, feedback, or questions?"]
[honeypot honeypot-949][submit "Submit"]