Grace Temple Missionary Baptist Church

MEMBERSHIP FORM

PERSONAL DETAILS
Name*
First Middle Last
Gender
Date Of Birth*
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DD
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Email*
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Cell Phone
CHILDREN DETAILS

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EMERGENCY CONTACT
Contact Name
Phone
Relation With Contact
We would like to have your permission to publish your information and picture in our church directory.
Consent:
If you are under 18 years of age we need initials of parent or guardian
Parents Consent:
Have you been Baptized?
If Yes, When?
MM
DD
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Are you joining our church?
Last Church Attended
Do you have any ministry experience (i.e. Usher or Deacon)?
If yes, which ministry:
When/Where You Can Attend Service?
If you have any questions, please call our office at (520) 622-8126