New Member Intake Form
Full Name
*
Prefix
First Name
Middle Name
Last Name
Suffix
Home Address
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Street Address
Street Address Line 2
City
State
Zip Code
Are you joining by:
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Baptism
Christian Experience
Letter
Watch-Care Member
E-mail
Home Phone Number
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-
Area Code
Phone Number
Please upload a headshot photo:
Would you like to receive updates via text message?
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Yes
No
Cell Number
*
-
Area Code
Phone Number
Marital Status
Single
Married
Divorced
Widowed
Date of Birth
*
-
Month
-
Day
Year
Date
Do you have a spouse joining as well?
*
Yes
No
Spouse's Full Name
*
Prefix
First Name
Middle Name
Last Name
Suffix
Spouse's Date of Birth
*
-
Month
-
Day
Year
Date
Spouse E-mail
example@example.com
Spouse Cell Number
-
Area Code
Phone Number
Please upload a headshot photo of your spouse
Would your spouse like to recieve text updates?
*
Yes
No
Do you have children we can add to this database?
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Yes
No
Enter your Child's Name, Birth Date, and Email Address (if applicable)
Child's Name
Birthdate
Email Address
1
2
3
4
5
Ministries you are interested in receiving more information about:
Audio/Visual Ministry
Beautification Ministry
Deacon Ministry
Deaconess Ministry
Greeter's Ministry
Kitchen Ministry
Men's Ministry
Senior Choir
Male Chorus
Young Voices of Ebenezer
Unity Choir
Homegoing Ministry
Kingdom Connection Ministry
Girl BeYOUtiful Mentorship
Boy's Mentorship Program
Outreach Ministry
Pastor's Aide
Scholarship Ministry
Senior Ministry
Trustees
Usher #1 Ministry
Usher #2 Ministry
Male Usher Ministry
Youth Usher Ministry
Visual Praise
Widows and Widower's Ministry
Youth Ministry
Sunday School
Vacation Bible School
Other
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