[The example below illustrates how your electronic visitor's card will look and operate.

     When visitors fill out and submit your electronic visitor's card, three things will happen…
     (1) immediately they will see an displayed “Thank you for filling out our visitor’s card. We will respond to you appropriately as soon as possible!” with a repeat of your basic contact information;
     (2) a copy of the submitted information is then sent via email to the Exploring God’s Word editor;
     (3) the editor will then review and forward a summary to your liason.

     At this time, all card submissions will come directly to the EGW editor before being sent to your subscription liason.  This is not an effort on our part to impose upon your privacy.  It is simply a matter of our form anticipates several general needs you and your visitors may have (for example, they may wish to express a comment or question, but you would like to know if they're willing to be contacted). Few visitors will select all possible options.  The raw report of the submitted information is rather confusing at first glance to read, especially for any items left unfilled or unchecked.  The editor will review the raw format of the information and then email a more-readable report to the person you've provided to us as your subscription liason; the editor will also screen for prank submissions (we do get those now and then).
     You are welcome to give it a test try now, if you'd like.  If you would like to see the report we would provide, then please include a valid email address when filling in the form.

     Thank you for visiting our website.

Mystreet church of Christ
1234 - 56th Street NE
Sample, SD 99999-9999
Phone: 987-654-3210
www.exploringgodsword.co/sd/sample		 Evangelist / Contact Person:
Real GoodGuy
1234 - 56th Street NE
Sample, SD 99999-9999
Phone: 987-654-3210
     Please fill out this visitor’s card so we may have a record of your visit and so we may know how we may help you.  Click “Submit Now” to send it to us.  Items #1 and #14 are required to submit the form.  Thank you.
* * * * * * * * * * * * * * * * * * * *
     If there is anything we can do to help you better understand the Scriptures, please contact us at the Mystreet church of Christ.  You may be struggling with questions and issues that we have already studied for God's solutions.  Our library has good reference materials and tools for successful Bible studying.  Many we use regularly and can't loan them out, but you are welcome to use them here at our building.  We don't claim to have all the answers, but we are willing to search the Scriptures with you to find the answers to your questions.
Form instructions:  Use "Tab" key or mouse to move between entry blanks.  When finished, click "Submit Now" button below.  To clear all entry blanks, click "Reset" button below.  Special note – except for items #11 & #12, using "Enter" key causes early submission of form.

EGW editor’s special note to…
… Microsoft Edge users and Google Chrome users:  Upon clicking "Submit Now" button below you should see a response note displayed in this viewing pane thanking you for filling out our visitor's card.  You may then select from either menu (the header pane above or the listing pane at your left) which item you would like to view next.  On rare occasion you may see an error message to the effect that Domain.com (my source & server for the code used to create this form) will not display the page as requested… this is a temporary condition due to the server experiencing a momentary high-traffic load.  If that happens, please use your browser’s back button to return to the form and click the "Submit Now" button again.  It should work, but if not, then please wait a few minutes and try again.  We really would like to hear from you.
… Firefox users:  Unfortunately, at present my vendor's code for the "Submit Now" button and the display of the thank-you response is glitchy in Firefox… I apologize for having no explanation to offer for this.  To help ensure successful submission please click the "Submit Now" button once, wait a few seconds, and then click "Submit Now" again.  If you provide a valid email and do not receive within a few days a personal reply from me or the congregation thanking you for using our visitor card, then please try again.  We really would like to hear from you.

1. Name: 
 
2. Address:  
3. City:  
4. State/Province:  
5. Zip/Postal Code:  
6. Telephone:  
7. E-Mail:  
8. Where do you usually attend church?  
9. What prompted you to visit our website?  

10. How may we help you?</
     [We also have several videotapes, audiotapes, books, and other study aids that you are welcome to use here at our building.]		 Private Counseling?
marriage
teen problems
personal
other		 Bible study interests?
course by mail
guided personal study
group / class study
Internet
radio
newspaper
TV		  

11. What question(s) about the Bible would you like to have answered?
 

12. What prayer requests or other needs might we be able to help you with?
 


13. Would you like us to contact you?

 about how your counseling / study interests
about the answer(s) to your bible question(s)
about your prayer requests / other indicated needs
by email when new materials are added to our website		  

14. Please check this box to indicate you are a real person filling out this form.
(This is a security-check to hinder automated softwares.)


Yes, I am a real person.

  
      Electronic submission form prepared by David G. Churchill; used by permission.  rev.061125-150507-211007
      For additional quality Bible-study materials, contact your local church of Christ or access Exploring God's Word at www.exploringgodsword.co.
      Send us your Bible-related questions.