Membership

First Name*

Last Name*

Email*

Phone Number*

Address Line 1*

Address Line 2

City*

County*

Postal Code*

Date of Birth (dd/mm/yyyy)*

Membership Type*— Select —In-PersonOnline

Are you a member of another local church?*

Yes

No

Preferred Name*

Marital Status*

Single

Married

Divorced

Widowed

Separated

Do you have any children?*

Yes

No

Occupation*

How long have you attended the church?*

When did you first come to the church?*

How did you hear about the church?*

Previous Attended Church – Name and Location*

Why would you like to become a member of the church?*

Please write a short paragraph about yourself, your family. Any skills, trades, hobbies, etc.*

Please write a short paragraph about yourself, your church background, where you attended over the past five (5) years, what your involvement in your previous church was, and why you left.*

Please tell us how you came to the church and how it is affecting your life right now.*

Please tell us about you, your family, and the vision God has placed in your heart.*

Have you been born again?*

Yes

No

Have you been baptized in water?*

Yes

No

Have you been baptized in The Holy Spirit?*

Yes

No

I am open to receive instruction and correction from Pastors and/or leadership specifically assigned to minister on behalf of the church.*

I am willing, if called upon, to be personally interviewed prior to acceptance of my membership application.*

Submit