Church Membership Form
2430 Sand RD, Vernon TX 76384
Name
First Name
Last Name
Gender
Male
Female
Other
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Anniversary
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Spouses 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
Child Name
First Name
Last Name
Gender
Male
Female
Other
Date of Birth
-
Month
-
Day
Year
Date
Child Name
First Name
Last Name
Gender
Male
Female
Other
Date of Birth
-
Month
-
Day
Year
Date
Child Name
First Name
Last Name
Gender
Male
Female
Other
Date of Birth
-
Month
-
Day
Year
Date
Child Name
First Name
Last Name
Gender
Male
Female
Other
Date of Birth
-
Month
-
Day
Year
Date
What are some of your talents and/or giftings?
Are you a born again Christian?
Yes
No
Could you share with us a short testimony of your salvation?
Would you like to be added to our text messaging system
Please Select
Yes
no
I would be willing to serve in the following departments
Praise and Worship
Hospitality
Greeters
Maintenance
Cleaning
Children's Ministry
Youth Ministry
Outreach
Prayer Team
Discipleship (Small Groups Leaders)
Security
Submit
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