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New Church Member Registration

New Church Member Registration Form
Please fill out the form below and submit to the church office.
Thank you!
 



    • Today's Date

    • Address







    • Home Phone

    • Anniversary Date

    • His Last Name, First, Middle

    • Brithday

    • Cell Phone

    • Email

    • Place of Employment:

    • Wk Phone Number

    • Church you are transferring from:

    • Baptized?


    • Date Baptized

    • In what church? Name & City, State

    • Her Last Name, First, Middle

    • Brithday

    • Cell Phone

    • Email

    • Place of Employment:

    • Wk Phone Number

    • Church you are transferring from:

    • Baptized?


    • Date Baptized

    • In what church? Name & City, State

    • 1st Child's Name: First, Middle, Last (Preferred)

    • Birthday

    • Baptism Date

    • 2nd Child's Name: First, Middle, Last (Preferred)

    • Birthday

    • Baptism Date

    • 3rd Child's Name: First, Middle, Last (Preferred)

    • Birthday

    • Baptism Date

    • 4th Child's Name: First, Middle, Last (Preferred)

    • Birthday

    • Baptism Date


Authentication Text*
(Enter the text in the image above into this field.)

NOTE: Do Not Alter These Fields: