EMMANUEL UNITED IN FAITH BAPTIST CHURCH
CHURCH MEMBERSHIP FORM
Submission Date
*
/
Month
/
Day
Year
Today's Date
Full Name
*
Mr.
Mrs.
Miss.
Prefix
First Name
Middle Name
Last Name
Main Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Main Phone Number
*
-
Area Code
Phone Number
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number
*
-
Area Code
Phone Number
Email Address
*
example@example.com
Date of Birth
*
/
Month
/
Day
Year
Date
NAME AND ADDRESS OF NEAREST OF KIN OTHER THAN ABOVE ADDRESS
*
Name and Address
MAKES THE FOLLOWING PUBLIC COMMITMENT
Please fill out the following information
ENROLL ME IN SUNDAY SCHOOL
*
YES
NO
ALREADY ENROLLED?
*
YES
NO
ACCEPTS CHRIST AS PERSONAL SAVIOUR AND LORD
*
YES
NO
DESIRES CHURCH MEMBERSHIP
*
BY BAPTISM
BY STATEMENT
BY LETTER FROM:
Address of Former Church
DEDICATES LIFE FOR CHURCH RELATED VOCATION
*
YES
NO
NAME OF VOCATION
*
REDEDICATES LIFE TO CHRIST
*
YES
NO
OTHER DECISION
*
SIGNED BY:
*
Submit
Should be Empty: