Bread of Life Deliverance Church Online Membership Form

Bread of Life Deliverance Church

A TEAM FOR CHRIST MINISTRYFOR OFFICE USE ONLY
Member Information Form

*Please complete ALL areas and provide accurate data so that the church can contact you as needed*
SECTION I: MEMBERSHIP REQUIREMENTS
Are you saved? *

I amI am not
*** You must be saved to be a member of Bread of Life Dilverance Church. If you are not saved but would like to recieve salvation, CLICK HERE ***
Do you believe the Bible is the Word of God?*

YesNo
Do you promise to abide by the bylaws of Bread of Life as long as it's within the guidelines of the Word of God?*

YesNo
SECTION II: GENERAL INFORMATION
Date*

MonthDayYear
Which location do you plan to worship?
SECTION III - HEAD OF HOUSEHOLD INFORMATION
Date of Birth*

MonthDayYear
Gender*

MaleFemale
Marital Status*
Full Name*

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone*

Area CodePhone Number
Cell Phone*

Area CodePhone Number
E-mail
Employer Name*
Occupation
Work Telephone
SECTION IV - SPOUSE INFORMATION
If married, is your spouse already a member of Bread of Life Deliverance Church?

YesNo
If no, is your spouse joining Bread of Life Deliverance Church with you today?

YesNo
Spouse Date of Birth

MonthDayYear
Spouse Gender

MaleFemale
Spouse Name

First NameLast Name
Spouse Cell Phone

Area CodePhone Number
Spouse Work Telephone

Area CodePhone Number
Spouse Email Address
example@example.com
Spouse Employer Name
Occupation
SECTION V - CHILDREN INFORMATION (Please list the members of your household that are joining with you.)
List each child's Name, DOB, and Gender:
SECTION VI - ADDITIONAL INFORMATION
Emergency Contact Name (an individual who does not live in household)*

First NameLast Name
Emergency Contact Number*

Area CodePhone Number
Do you have other relatives who are currently members of Bread of Life Deliverance Church?

YesNo
If yes, please list their name(s) and relationship to you:
Please tell us your top three spirituals gifts (obtained from your spiritual gifts test results)
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Based on your spiritual gift(s), which ministry would you like to be apart of?
Administration
Apostleship
Craftsmanship
Discernment
Evangelism
Exhortation
Faith
Giving
Healing
Helps
Hospitality
Intercession
Leadership
Mercy
Miracles
Pastor/Shepherd
Prophecy
Service
Teaching
Tongues
Words Of Knowledge
Words of Wisdom
Upload a photo of yourself (and joining spouse)

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SECTION VII - MEMBERSHIP COVENANT

I understand upon completion of orientation that I will be a member of Bread of Life Deliverance Church and will submit to the by-laws as long as they are in the guidelines of the bible and the spiritual authority ordained by God and given to the senior pastor, Terry Hamilton. I agree with the vision and purpose of this assembly and will make every effort to make it successful.
Sign below using your curser as your writing utencil.
Signature (if married and both are joining, both signatures are needed):

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Should be Empty:

Bread of Life Deliverance Church

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