Membership & Decision Record

Church Membership & Decision Record

* Indicates required field

Date *

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Name and Address of Nearest Relative Other Than Above Address *

Choose Any *

Accepts Christ as Personal Savior and Lord Desires Membership in this Church

Choose Any *

By Baptism By Statement

By Letter From *

Church Address *

Choose Any *

Dedicates Life for Church-Related Vocation Rededicates Life for Christ

Other Decision.... *

Submit