Member Information

Family Household Information

First and Last Name:

Phone Number:

Mailing Address:

City:

State:

Zip:

Email Address:

Are you willing to help usher? Ushering can be signed up for monthly or just a day here and there.

Yes
No

Are you willing to read scriptures during worship occasionally? I go alphabetically along those who wish to read so your name would only come up every few months.

Yes
No

If yes, please write the names of family members willing to read:

Do you want to receive our monthly newsletter via email? This is also available on the Publishings page of our website if you don't want emails.

Yes
No

Are you interest in our Simply Giving Program for offering? This is not required - it's just something we offer for those who wish to give online.

Yes
No

Are you interested in updating our Church Directory?

Yes
No

Are you ok with your birthday and/or anniversary being posted in the monthly newsletter?

Yes
No

First Member

First Name:

Middle Name:

Last Name:

Maiden Name:

Email Address (if different from first page):

Wedding Anniversary (if applicable):

Cell Phone:

New Members Only

Prior Church:

Denomination:

City/State/Zip:

Birth

Date:

Location:

Baptism

Date:

Church:

Location:

Pastor:

Sponsors:

Confirmation

Date:

Location:

Pastor:

Second Member

First Name:

Middle Name:

Last Name:

Maiden Name:

Email Address (if different than first page):

Cell Phone:

New Members Only

Prior Church:

Denomination:

City/State/Zip:

Birth

Date:

Location:

Baptism:

Date:

Church:

Location:

Pastor:

Sponsors:

Confirmation:

Date:

Location:

Pastor:

This portion is for any children/dependents. You can fill out & submit as many times as needed.

Relationship:

First Name:

Middle Name:

Last Name:

New Members Only

Prior Church:

Denomination:

City/State/Zip:

Birth

Date:

Location:

Baptism:

Date:

Church:

Location:

Pastor:

Sponsors:

Confirmation:

Date:

Location:

Pastor: