New Member Reporting

This form is meant to be filled out by the local church clerk or pastor.

New Member Reporting Form

Phone

This field is for validation purposes and should be left unchanged.

Name of new member*

First Last

Name of church joined*

Member by*

Baptism

Profession of Faith

Re-baptism

Baptized by*

Date of baptism*

Place of baptism*

Name of parents (if living at home)

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home phone

Cell phone*

Email address

Date of birth*

Marital status*

Gender*

If new family, list non-member family members residing with member

Name of person reporting*

First Last