Full Name

Name I go by / prefer to be called

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone

(###)

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Other Phone (if helpful)

(###)

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Birthday

YYYY

Anniversary Date (if married)

YYYY

Children (if any)

Please list all children in the space below. Please include Name, Birthdate, Grade, M/F, and whether Baptized

Purpose(s) of the Church I Am Most Interested in Serving

Check one or more

Facilitate new relationships with Jesus (Evangelism)

Incline our hearts to the Lord (Worship)

Relate to one another in intimate community (Fellowship)

Stimulate one another to grow to maturity in Christ (Discipleship)

Tend to the needs of others in love (Ministry)

I Will Be Joining By

Select only one of the following from the dropdown menu below PROFESSION OF FAITH & BAPTISM I have never been baptized in any Christian church or made a public profession of my faith in Jesus Christ and wish to do so now. REAFFIRMATION OF BAPTISMAL COVENANT I have been baptized, but have never publicly professed my faith in Jesus Christ by joining a church and wish to do so now. REAFFIRMATION OF FAITH I once publicly professed my faith and joined a church, but recently I have been inactive. Now I wish to reaffirm my faith in Christ. CERTIFICATE OF TRANSFER I have recently been active in another church and wish for you to write for a certificate of transfer.

New Member Information Form