Membership Application

MEMBER INFORMATION: *

First Name

Last Name

Date of Birth: *

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Home Phone: *

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Mobile Phone: *

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Address: *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Approximate Date or Year: *

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ADDITIONAL MEMBER INFORMATION:

First Name

Last Name

Date of Birth:

MM

DD

YYYY

Home Phone:

(###)

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Mobile Phone:

(###)

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Approximate Date or Year:

MM

DD

YYYY

DISCIPLESHIP OPPORTUNITIES: *

Check all that you'd like to hear more about.

Bible Fellowship Classes

Kids’ (Birth-5th) Activities

Student (6th-12th) Activities

Weekend Groups

Weekday Women’s Groups

Weekday Men’s Groups

ON CAMPUS SERVICE OPPORTUNITIES: *

Decorating

Welcome Host

Hospitality

Memorial Services

Security

Worship & Music

Greeters

Online Host

Inreach

Tech Arts

Prayer

Baptism

Missions

Homebound

Landscaping

Men's Ministry

Kid's Ministry

Lord's Supper

Golf Cart Drivers

Hospital Visitation

Medical Response

Women's Ministry

Student's Ministry

Christian Life Ministries

OFF-CAMPUS MISSIONS: *

Check which people groups you’d like to serve.

The Poor

The Elderly

Children

Homeless

The Hungry

International

First Responders

Other