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| First & Last Name: |
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| Date of Birth |
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| Address Street 1: |
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| Address Street 2: |
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| City: |
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| Zip Code: |
(5 digits) |
| State: |
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| Home Phone: |
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| Cell Phone: |
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| Email: |
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| Marital Status: |
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| Spouse Name: |
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| Spouse Cell: |
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| Anniversary Date: |
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| #1 Child’s Name, D.O.B, Grade: |
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| #1 Child Baptized: |
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| Baptized Date: |
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| #2 Child’s Name, D.O.B, Grade: |
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| #2 Child Baptized: |
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| Baptized Date: |
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| #3 Child’s Name, D.O.B, Grade: |
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| #3 Child Baptized: |
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| Baptized Date: |
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| #4 Child’s Name, D.O.B, Grade: |
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| #4 Child Baptized: |
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| Baptized Date: |
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| #5 Child’s Name, D.O.B, Grade: |
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| #5 Child Baptized: |
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| Baptized Date: |
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| #6 Child’s Name, D.O.B, Grade: |
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| #6 Child Baptized: |
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| Baptized Date: |
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| Previous Church: |
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| Pastor: |
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| Years As Member: |
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| City/State: |
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| Phone: |
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| May we contact your previous Pastor? If not, why?: |
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| Received baptism by immersion in Jesus’ name (Acts 2:38)?: |
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| Baptism of the Holy Ghost (by evidence of tongues)?: |
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| Name of a relative not residing with you: |
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| Address: |
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| City/State: |
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| Zip Code: |
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| Electronic Signature of Member: |
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| Today’s Date: |
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SPIRITUAL GIFTS are God-given graces (special abilities, offices, or manifestations) meant for works of service, to benefit and build up the body of Christ as a whole according to God’s sovereign will or as He determines. |
SPIRITUAL GIFTS:
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OTHER SPIRITUAL GIFTS NOT LISTED:
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SKILLS AND TALENTS refer to proficiency, facility, or dexterity that is acquired or developed through training or experience. An art, trade, technique developed talent or special ability. |
| SKILLS AND TALENTS: |
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| OTHER SKILLS AND TALENTS NOT LISTED: |
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| ACTIVELY INVOLVED IN MINISTRIES/ACTIVITIES: |
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| OTHER MINISTRIES/ACTIVITIES NOT LISTED: |
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