Grace New Member Form

Today's Date *

MM

DD

YYYY

Date of Birth *

MM

DD

YYYY

Local Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Alternate Address, if applicable

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Cell Phone *

(###)

###

####

Other Phone

(###)

###

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Marital Status *

Married

Single

Widowed

Divorced

Engaged

If you are married, please provide your anniversary date, including year:

MM

DD

YYYY

Have you been baptized? *

Yes

No

Joining by: *

Transferring from another church

Reaffirmation of Faith

Profession of Faith

Affiliate Membership (Primary church membership elsewhere)

Have you ever served as an Elder in a Presbyterian Church? *

Yes

No

If not, are you interested in joining a Connect Group, Bible Study, or area of ministry? *

Yes

No

Maybe