Membership Application

Your Details

Name, contact and date of birth

Title

First Name^*

Last Name^*

Email Address^*

Phone Number

Date of Birth

Personal Background

Helps us get to know you

Gender

Marital Status

Occupation

Next of Kin / Emergency Contact

Residential Address

Where we can reach you

Address Line 1

Address Line 2

Postal Code

Country

City

State/Province

Your Testimony

Tell us about your walk with Christ

Personal Testimony^*

Please share how you came to faith in Jesus Christ

Why do you want to join this church?

Church Background

Previous experience and how you would like to serve

Previous Church Experience

Spiritual Gifts & Service Areas

Baptism

Have you been baptized?

I have been baptized

Church Agreement

Please confirm the following before submitting

I accept and agree to abide by the church constitution and bylaws^*

I accept the guidance and authority of the church leadership^*

I am currently a member of a secret society

Reference 1

Required — someone who knows you well

Reference 1 - Name^*

Reference 1 - Phone^*

Reference 1 - Relationship^*

e.g., Pastor, Friend, Family

Reference 2

Optional — a second contact if you have one

Reference 2 - Name (Optional)

Reference 2 - Phone

Reference 2 - Relationship

Application Form

Estimated time: ~10 minutes