Membership Form
Date joining :
*
-
Month
-
Day
Year
Date
Membership Status
*
In-Person Member
Virtual Member
Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you accepted Jesus Christ as your Lord and Savior
*
Yes
No
Have you received water baptism (immersion)?
*
Yes, I have received water baptism
No, but I would like to receive water baptism
No, and I would not like to receive water baptism
I have someone with me who is seeking to receive water baptism
Spouse Information ( if applicable)
Spouse ( if applicable)
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you consent to receive communications from St. Paul Baptist Church?
*
Please Select
Yes, I consent
No, I do not consent
Children ( if applicable)
Child 1
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Child 2
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Child 3
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Child 4
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Child 5
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Child 6
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Child 4
First Name
Last Name
Submit
Should be Empty: