Membership Form

(Mr/Ms/Mrs)

Last

Mailing Address (if different from above)

(Street Number & Name)

(Apt/Pvt)

(P.O. Box if any)

(City)

(Province)

Address (No P.O. Box)

(Zip)

(Phone Number)

Name & Address of Church Attended in Last Three (3) Years,

Do You belong to any Organization?

Name

Address

Phone Number

Contact Number

How did you know about us?

Do you have an Email address?

Are You Ordained?

If yes, please give date and title

Are you a licensed minister in the province of Ontario?

Are you in good standing?

I am (check one)

I am (choose the appropriate box)

If you wish to share your birth date, this information will be used ONLY for the purpose of celebrating with you.

Did you attend the membership classes? If yes,

Did you attend the membership classes?

and Year

Do you pledge to support the Social and Spiritual Ministries of this local assembly without prompting, and as led by the Holy Spirit through volunteer, prayer, and finance?

Print Name

Date

Custom Signature Pad

Signature

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OFFICIAL USE ONLY

Custom Signature Pad

(Approved By)

Custom Signature Pad

(Pastor)

On this

day of the

month of the year

Love your neighbor as yourself

Membership Form

Membership Form

Love your neighbor as yourself

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