Full name __________________________________________  

Address ___________________________________________  

Phone _________________________   Email __________________________________

Have you been baptized? ________ confirmed? _______  

Do you currently hold membership in another church? _________

    - if so, which church? _________________________________

Attached is a copy of our Statement of Faith. After reading it carefully, please check one of
the following:

    _____ I am in full agreement with the Statement of Faith.

    _____ I am in partial agreement with the Statement of Faith

Our Church Constitution states the expectations of members: "Members shall pledge
themselves to attend the regular worship of the church and the celebration of the Lord's
Supper; to live the Christian life; to share in the life and work of the church; to contribute to
its support and benevolence; and to diligently seek the spiritual welfare of the membership of
the community."  

Are you willing to pledge yourself to these responsibilities? ______  

How would you describe how things are between you and God right now?  

If you died tonight, are you certain that you would go to heaven?  

    yes ____ no ____ not sure ____

If God asked what you are relying on to get yourself into heaven, what would you say?  

Was there ever a time in your life when you chose to turn from your sin and accepted Jesus
as your Lord and Savior for the rest of your life?  

    yes ____ no ____ not sure ____

If yes, please describe the circumstances surrounding your decision to accept Jesus.
Membership Application