Student Connect Form • East Ellijay Baptist Church, Inc.

Welcome Students

We would love to get to know you!

Please enter in the info below so we can get to know you better and serve you well. Please reach out to our youth Pastor, Seth Teegarden with any questions. 678-982-0838

First Name *

Last Name *

Preferred Name

Mobile Number *

Email Address

Date of Birth

School Grade

Tell us a little more

What School do you attend?

Which School in Fannin?

Which School in Pickens?

Tell us more about your current Education

Please provide a name and contact info for at leaset one Parent/Guardian

Parent/Guardian Name

Parent/Guardian Cell #

Parent/Guardian email

I want to know more about...

Tip: What information can we provide you about East Ellijay Baptist Church?

How can we pray for you?