Name *

First Name

Last Name

Date of Birth

MM

DD

YYYY

Spouse Name

If applicable

First Name

Last Name

Spouse Date of Birth

MM

DD

YYYY

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Membership & Groups

I am interested in joining the following:

Faith Covenant Church Membership

Home Groups

Women's Bible Study

Faith Bible Studies (Sunday School)

Serving

I am interested in serving....

Nursery

Faith Kids

Faith 5.8 (Middle School)

Faith 9.12 (High School)

Worship Team

Sound/Media Team

Security Team

A Ministry Team (Women's Min, Men's Min., Stewardship, Compassion, etc.)

I have decided...

To follow Jesus with my life!

To get baptized!