CHURCH MEMBERSHIP APPLICATION

First Name

Middle Name

Last Name

Preferred Name

Previous Last Name

Home Address

Mailing Address

Mailing City

Mailing State

Mailing Zip Code

Phone

Phone 2

Birthday

I desire membership by:

Promise of Letter from another church stating I am a member

Statement of Faith (I have been a member of a Baptist church but am presently another denomination)

Profession of Faith and Baptism (I am a new believer)

Reaffirmation of Faith and Request for Baptism (I have previously professed Christ but have never been baptized by immersion or as a believer)

If joining by promise of letter or statement of faith, please provide name and location of church where you are presently a member.

Do you have relatives who are members of Earle Street Baptist Church? If so, provide their name(s) and relationship.

Please list name, birthdate (including year), and relationship of others living in the home (children/spouse).

Welcome Home!