New Member Application

First name

Last name

Address

Email

Phone

Birthday

Month

Day

Year

Spouse's Name (If Applicable)

Spouse's Birthday

Month

Day

Year

Wedding Anniversary

Month

Day

Year

Children's Names/Ages (If Applicable)

Who introduced you to the church, or who have you met since attending?

Please check all that apply:

Interest in a pastoral visit

Interest in information regarding baptism or confirmation

Interest in receiving monthly church newsletter

Interest in being included in the church directory

Are you transferring from another church?

Yes

No

If you are transferring from another church, please list the name of that church

Please tells us a little bit about yourself and what brought you to our church: