Church Membership Form

Friendship M B C, Inc. Membership Application

All information on this form is strictly confidential
Full Name*

PrefixFirst NameLast NameSuffix
Date of Birth*

MonthDayYear
E-mail*
example@example.com
Home Phone Number*

PrefixNumber
Mobile Phone Number

PrefixNumber
Preferred method of communication
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you believe in Jesus?*

YESNO
Have you been baptized?*

YESNO
If "YES", what is the name and location of the church where you were baptized?*
Type N/A if this does not apply to you
If "NO", are you willing to be baptized?*

YESNO
Should be Empty:

Friendship M B C, Inc. Membership Application