Kingdom Cohesion Membership Application

Kingdom Cohesion Membership Application

Complete this application to share your background, spiritual involvement, gifts, and availability for membership consideration.
Applicant Information
Full Name

First NameMiddle NameLast Name
Preferred Name
Gender
Date of Birth

MonthDayYear
Date
Age
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Preferred Method of Contact
Church & Spiritual Information
Are you currently an active member of your church?
Current Church Home
Church Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Pastor's Name

First NameMiddle NameLast Name
Pastor's Email
example@example.com
Pastor's Phone
Please enter a valid phone number.Format: (000) 000-0000.
How long have you attended this church?
Are you currently being discipled or mentored by a spiritual leader?
If yes, provide the name of your mentor or disciple leader
How would you describe your relationship with Jesus Christ?
Membership Interest
Why do you want to become a member of Kingdom Cohesion?
How did you hear about Kingdom Cohesion?
If Other, please specify
Gifts, Talents & Contributions
Gifts, talents, and areas of contribution

Other
Other gifts or talents
Please describe your experience
Community Engagement
Which community initiatives are you interested in supporting?

Other
Other interests or ways you would like to serve
Availability
How often would you like to participate?
Preferred Days
Emergency Contact
Emergency Contact Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Optional Background Information
Have you ever served in ministry leadership?
If yes, please explain
Are there any accommodations or support needs we should be aware of to help you serve effectively?
Applicant Certification
Applicant Signature
Date

MonthDayYear
Date
Should be Empty:

Kingdom Cohesion Membership Application

Applicant Information

Church & Spiritual Information

Membership Interest

Gifts, Talents & Contributions

Community Engagement

Availability

Emergency Contact

Optional Background Information

Applicant Certification