MEMBERSHIP FORM

Name

First Last

Gender

Male
Female

Date of Birth

Marital Status

Wedding Anniversary (If any):

Profession

Current Occupation:

Hobbies

Age Group

Department / interest(s) (e.g. Choir, Ushering, Protocol):

Ministry / interest(s) (e.g. Prison, Hospital, Teaching, Music, Drama):

What small group do you belong? (e.g. Golden M&M, Synergy 28):

Class completed:

Address

Street Address Address Line 2 City State ZIP Code

House Phone #:

Mobile #:

Email

What can we do differently to improve our church? *

Privacy Policy:

Please note that your privacy is very important to us and we treat each data with strict confidentiality. This form is designed to help us serve you better and be more effective in our responses to your individual needs.

CHURCH MEMBERSHIP FORM

Privacy Policy: