Are you a born again Christian?
Yes
No
Ebenzer Ethiopian Church Portland Membership Form
16575 SE Webster Ave, Milwaukie, OR 97267
Name
First Name
Last Name
Gender
Male
Female
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What church did you go to before?
Pastor's Name
First Name
Last Name
Church or Pastor Phone Number
Please enter a valid phone number.
Name of Spouse/Family Guardian
First Name
Last Name
Have you been Baptized before?
Yes
No
The Church Name of were you Baptized?
Date
-
Month
-
Day
Year
Date
What are some of your Ministries/talents and/or giftings?
What role you used to play in your church , if any?
Could you share with us a short testimony of your salvation?
Signature
Sumit
Sumit
Should be Empty: