Church Membership Form

CPBC MEMBERSHIP ENROLLMENT FORM

All information on this form is strictly confidential
Full Name*

First NameLast Name
Gender*

MaleFemale
Date of Birth*

MonthDayYear
E-mail*
Mobile Phone Number

PrefixNumber
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What are your interest?
Name of Parent/Guardian (s)
Are you a current member?*

YESNO
If Yes, When were you enrolled?
What are some of your talents and/or giftings?*
What role do you play in your church youth group, if any?
Are you a born again Christian?*

YESNO
If YES, Could you share with us a short testimony of your salvation?
Thank You

Thank you for allowing us to update the church database.
All correspondence to The Administration Office, J. Whiteside || P.O. Box 411170, Dallas, TX 75241 || E-mail: collegeparkbaptistchurch@yahoo.com|| Cellphone: 214-779-5703 || FACEBOOK: @Collegeparkchurchdallas || WEBSITE: collegeparkchurchdallas.org
Should be Empty:

CPBC MEMBERSHIP ENROLLMENT FORM