Page 4 | Beit Zayit Messianic Congregation

Use this form to let us know about decisions or prayer requests, or to let us know you're here. Please complete the following fields, then click Submit.

Name (Required)

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Birthday

When were you born?

How did you hear about us?

Friend told me about

Online (Website, Google, Facebook, Youtube)

Other

If "OTHER" above ,what other way did you hear about us?

I am a:

First Time Guest

Second Time Guest

Regular Attender

Member

Prayer Requests

How can we pray for you?

My Decision Today (click all that apply): I want to...

Let us know if you made a decision today or if you want us to follow-up with you.

Commit my life to Yeshua (Jesus)

Renew my commitment to Yeshua (Jesus)

Participate in Mikvah (Baptism)

Receive emails about upcoming events

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Speak with a leader

Questions? Comments?

Beit Zayit Messianic Congregation

1200 Springhill Rd
Staunton, VA 24401

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