City Of God Revival Center Online Membership Form

COGRC ONLINE MEMBERSHIP FORM

GOD IS ABLE "Ephesians 3:20"
Name*

PrefixFull NamesMiddle NameSurnameSuffix
Date*

DayMonthYear
Date
Country of birth*
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Postal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Marital Status*

MarriedWidowedSingleDivorced
Gender/Sex*

MaleFemale
Persona phone number*

Country CodeArea CodePhone Number
Alternative Phone number
Email address

Confirmation Emailexample@example.com
Spouse Name
DEPENDANTS

If you have family members who will attend City Of God Revival Center enter them below (click here to move next)
Main member's dependant
Next of kin*

PrefixFirst NameMiddle NameLast Name
Relationship
DateTime*
Birth Date*

DayMonthYear
What will you wish to do in the church?*

Greeter/UsherTechnical departmentWorshipMediaJoin relevant operation/departmentOtherPraise Dance Team
How do you rate your bible knowledge?
Please type your favorite bible verse
Type book, Chapter and a verse
Will you support media platforms of City Of God Revival Center?
Declaration

I (the undersigned) hereby declare that the information provided in this form is true and reliable. By signing this form I am in agreement to be a member of City Of God Revival Center.
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COGRC ONLINE MEMBERSHIP FORM