NEW MEMBER INFORMATION SHEET
Bethlehem Baptist Church - 500 S. Frances - Terrell, TX 75160
Date Joined
*
Your Name
*
First Name
Last Name
Your Date of Birth
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Check "Title" Options that Apply
Mr.
Mrs.
Ms.
Dr.
Check Options that Apply
Male
Female
Married
Single
Name of Spouse
(If Married)
Spouse Date of Birth
Phone: Home
*
Home
Email
*
example@example.com
Phone: Cell
*
Cell
Household Dependents (click the "+" icon to add more dependents )
Please check all that do apply
I desire to become a Member
I have Christian Experience
I desire to accept Jesus Christ as Lord and Savior
Please check all that do apply
I desire to be Baptized
I desire to join under watch-care
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