Diverse People Worshiping
ONE God As ONE
   
MEMBER FORM

MEMBERSHIP INFORMATION FORM

To Assist us in keeping accurate records, please complete this form and return it to the First Assembly of God church office. Thank you!
First Name Last Name
Phone# : Work #: Ext: Cell#:
Email Address: Street Address:
City: State: Zip Code:
Employer
Brith date: Conversion date
Baptism date Holy Spirit baptism date
Is your spouse in a Life Group If yes, who is the leader?