New Member Application

We ask that you read, understand and with the help of the LORD, live by the following committal statements. 1. Be faithful in my church attendance. 2. Submit to spiritual authority as established in this local assembly. (Hebrews 13:7, 13) 3. Be willing to regularly support this local assembly with my tithes and offerings. (Malachi 3:10, I Corinthians 16:2)

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Name

First

Last

Date of Birth

Home Address (Please include City, State and Zip)

Phone Number

Email Address

Marital Status

Spouse Name

First

Last

Child's Name

First

Last

Date of Birth

Child's Name

First

Last

Date of Birth

Child's Name

First

Last

Date of Birth

Have you accepted Jesus as Your Lord and Savior?

Have you received the baptism of the Holy Spirit with the evidence of speaking in other tongues?

Have you received the baptism of water by full body immersion?

Have you been a member or regular attendee of another church?

Previous Church Information Name,

Name any position you held, if any, while attending another church. (i.e. Deacon, usher, choir member, etc

How did you first hear about our church?

Gifts,Talents, Skills, and Interest (Please write N/A if not applicable)

Emergency Contact Name

First

Last

We will gladly attempt to contact someone for you, in case of an emergency

Phone Number

Relationship

Applicant Signature

Date

Senior Pastor Signature

Date

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