NEW MEMBERSHIP FORM
PASTOR - Bishop Gary McFarlin
DATE_____________
NAME ___________________________
ADDRESS _________________________________
CITY________________STATE__________ZIP________
TELEPHONE NO _________________ check here if no is
private _________
Email address: _________________@_________
DATE OF BIRTH: mm _____
day ___ yr _____ (year will not be printed on reports)
Check one below
married____________
single__________ divorced__________
widowed_________
If married, Anniversary
Date: mm _____day____ yr ______
OTHER MEMBERS OF
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NAME |
RELATIONSHIP SON,DAUGHTER,GRANDPARENT, GRANDCHILD, NIECE, ETC. |
DATE
OF BIRTH mm/day/yr format (yr will not be printed on reports) |
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With what group you are interesting in working? ______________________
Have you been baptized in a church with similar beliefs? If not, are you willing to be baptized, here? Submit Form