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East Main Street Church of God
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Membership Profile
Please complete the form below to tell us a little more about yourself and your family!
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Thank you for your response. ✨
First Name
(required)
Last Name
(required)
Phone number
Email
Date
YYYY-MM-DD
Spouse’s First Name
Spouse’s Last Name
Spouse’s Phone Number
Spouse’s Email
Spouse’s Birthday
YYYY-MM-DD
Anniversary
YYYY-MM-DD
Child 1 First Name
Child 1 Last Name
Child 1 Gender
Male
Female
Child 1 Phone number
Child 1 Email
Child 1 Birthday
YYYY-MM-DD
Child 2 First Name
Child 2 Last Name
Child 2 Gender
Male
Female
Child 2 Phone Number
Child 2 Email
Child 2 Birthday
YYYY-MM-DD
Child 3 First Name
Child 3 Last Name
Child 3 Gender
Male
Female
Child 3 Phone Number
Child 3 Email
Child 3 Birthday
YYYY-MM-DD
Child 4 First Name
Child 4 Last Name
Child 4 Gender
Male
Female
Child 4 Phone Number
Child 4 Email
Child 4 Birthday
YYYY-MM-DD
Street Address
City
State
Zip Code
Are you a born again Christian
Yes
No
Is there anyone in your household who is not a born again Christian that we can help you pray for?
Yes
No
Have you ever been baptized in water?
Yes
No
If no, are you interested in being baptized in water?
Yes
No
Is there anyone in your household who has never been baptized in water who would be interested in doing so?
Yes
No
Are you a member of East Main Street Church of God?
Yes
No
If no, are you interested in becoming a member of East Main Street Church of God?
Yes
No
Is there anyone in your household who is not a member of East Main Street Church of God who would be interested in doing so?
Yes
No
Would you or someone in your household like to receive text alerts from East Main Street Church of God?
Yes
No
Text
Would you be willing to serve in an area of ministry at East Main Street Church of God?
Yes
No
I already serve
If yes, what area of ministry are you interested in?
Select one option
Children's Ministry
Student Ministry
Worship Team
Media Team
Welcome Team
Community Outreach
Special Events
Administration
If you already serve in an area of ministry, please list them below.
Is there anyone in your household who would be willing to serve in an area of ministry at East Main Street Church of God?
Yes
No
If yes, please type the name of each person and describe the area of ministry they are interested in.
Please take a moment to describe some of your talents and/or giftings.
Please take a moment to describe some of the talents and/or giftings of those who live in your household.
Thank you for taking the time to complete our Membership Profile! Have a great day!
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