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MEMBERSHIP APPLICATION
Title
Mr.
Ms.
Mrs.
First Name
First Name is required.
Last Name
Last Name is required.
Date Of Birth
Date Of Birth is required.
Address
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
Home Phone
Cell Phone
Cell Phone is required.
Work Phone
Email
Email address is not valid
Email is required.
Occupation
Marital Status
Married
Single
Divorced
Widowed
Spouse First Name
Spouse Last Name
Anniversary Date
List below all children (names/ages) in your family living at home
List below the churches where you have been a member (name, city, state, years involved)
Please state briefly your reason for leaving
Have you received Jesus Christ into your life as your Lord and Savior
Yes
No
Not Sure
Have you received Jesus Christ into your life as your Lord and Savior is required.
Date of Decision
Have you been baptized since your decision to receive Christ
Yes
No
Have you been baptized since your decision to receive Christ is required.
By what method were you baptized
Sprinkling
Pouring
Immersion (Triune)
Immersion (Single)
By what method were you baptized is required.
Have you read the Statement of Faith of our church
Yes
No
Have you read the Statement of Faith of our church is required.
Are you in agreement with the Statement of Faith
Yes
No
Not Sure
Are you in agreement with the Statement of Faith is required.
If there is an area with which you are not in agreement, please state briefly what that is
Are you willing to submit to the leadership, decisions and directions of the Elders of Grace Community Church
Yes
No
Are you willing to submit to the leadership, decisions and directions of the Elders of Grace Community Church is required.
List any hobbies, interests, talents or spiritual gifts that could be used by the Lord as a ministry in our church
List any hobbies, interests, talents or spiritual gifts that could be used by the Lord as a ministry in our church is required.
Briefly state what you believe the Christian's financial responsibility is to the local church
Briefly state what you believe the Christian's financial responsibility is to the local church is required.
Please tell in your own words how you received Jesus Christ into your life and what He means to you
Please tell in your own words how you received Jesus Christ into your life and what He means to you is required.
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