Church Membership Application Date * MM DD YYYY Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Birthdate * MM DD YYYY Makes the Following Public Commitment * Accept Christ as personal Savior and Lord Desires Membership in the Church by Baptism Desires Membership in the Church by Statement Desire Membership by Letter from previous Church Previous Church and Address (if joining by letter) Thank you!
