New Membership Form
8932 Quincy Ave. Cleveland, Ohio (216) 231-2985 Rev. Jeremy Wanton, Senior Pastor
Name
*
First Name
Last Name
Gender
*
Male
Female
Other
Date of Birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Member Number
Relationship Status (married, divorced, single, widowed etc.)
Spouse Name (if applicable)
*
First Name
Last Name
Emergency Contact
*
First Name
Last Name
Phone Number
Relationship
Address
City, State, Zip Code
Do you have any children?
*
Yes
No
If so, how many and are they members of Union Grove as well?
Do we need to prepare a resignation letter to send to your previous church? If so, what is the name of your church? (Provide address and contact info if possible)
What impacted your decision to join Union Grove?
Do you plan on sharing Jesus and inviting someone to your new church?
Yes
No
Comments:
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