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Personal Decision
*
Today's Date
I am
A. making a commitment to accept Jesus Christ as my Lord and Savior.
B. interested in becoming a member of the New Life Church family.
I desire...
select one
Baptism
Membership
Baptism & Membership
*
I have accepted Christ as my Savior, and I have been baptized.
NO
YES
If already baptized, let us know the year you were baptized, or age at baptism:
Personal Information
Title
Mr.
Mrs.
Ms.
Dr.
*
Full Name
*
Birthdate
*
Marital Status
Single
Married
Widowed
Address
City
State
Zip Code
Address (If outside of USA)
*
Primary Phone
*
Primary Email
Secondary Email
Spouse's Name
Spouse's Phone
My spouse is joining New Life today as well:
NO
YES
If Under 18...
Name of Parent/Guardian(s)
Relationship (ex: Mother, Father, Grandmother, Legal Guardian, etc.)
Parent/Guardian Phone
Parent/Guardian Email
Family Information
Spouse's Contact Number
Spouse's Email
Child #1: First & Last Name
Child #1: Date of Birth
Child #1: Gender
Male
Female
Child #2: First & Last Name
Child #2: Date of Birth
Child #2: Gender
Male
Female
Child #3: First & Last Name
Child #3: Date of Birth
Child #3: Gender
Male
Female
My Prayer Request
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