New Member Application February 22, 2022 | No Comments Application ← BackThank you for your response. ✨ Name(required) Marital Status Select an option Married Widowed Divorced Single Email(required) Birthdate (YYYY-MM-DD)(required) Address Cell Number(required) Phone Number Allergies / Special Needs Please list below each child that will attend Sunday School/ *Please fill in ALL categories including birthdate /age: NameBirth DateAgeGradeAllergiesSpecial Needs Child 1 Child 2 Child 3 Child 4 Have you accepted Jesus Christ as your personal Savior? Yes No Have you been baptized? Yes No Do you have any Christian Experience? Do you have any professional credentials that you would like to list? Do you have any special talents or skills? If Yes, please explain briefly: Please advise us of your recent church affiliation. Did you leave on good terms? If no, would you like to discuss with the ministry leadership? Emergency Contact Information? By submitting this form you give Lighthouse Community Church permission to take photographs of you and your children to use in church publications (e.g., website, newsletters, Facebook and other media or public platforms. Also by submitting your information, you’re giving us permission to email you. You may unsubscribe at any time. SendSubmitting form Δ
