What We Believe

NEW MEMBERSHIP INFORMATION FORM

Name

Email address

Phone number

Date of birth

Address

Gender

Marital Status

What is your Maiden Name? [if applicable]

Spouse's name and phone number [if applicable]

Spouse's emaiI address [optional]:

Do you have any children under 18 years old? If yes, please enter information for each child:

Yes

Please enter the name(s) of your child(ren)

Please enter the information for a person(s) who may be contacted on your behalf:

Contact# 1 - Name and Phone Number

Contact# 2 - Name and Phone Number

Are you saved?

Yes

I’m not sure

When were you saved?

Would you like to be saved?

Yes

Were you baptized?

Yes

Would you like to be baptized?

Yes

Were you ordained in your previous ministry?

Yes

What was your Title/Office?