East Pointe Church - Membership

First Name

Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Email

Birthdate

Please Check

I have been born again

I would like to know more about being born again

If you have been born-again, briefly relate your personal salvation experience:

Please Check

I have been baptized by immersion

I have not yet been baptized by immersion

If you have been baptized by immersion, please relate when and where:

My current church membership is with (Church name and address)

Preferred areas of ministry

Please provide names, birthdays, and school grade for each member of your family for church records:

*I am in agreement with the doctrinal position, ministry philosophy, and direction of East Pointe Church and am submitting this request for membership.

Signature