General information:
Print your first and last name with middle initial
_______________________________________________
By what name do you prefer to be called?
____________________________________________________
Address_________________________________________________________________________
Home phone________________________________ E‐mail _______________________________
Employment_____________________________________________________________________
Business address ______________________________________________________
Business phone _________________________
Date of application for membership _________________________
Birthdate_________________________
Church and address to which you last belonged
_______________________________________________
______________________________________________________________________________
What was the denomination of this church?
____________________________________________________
Who is this church's present pastor?
___________________________________________________________
When did you last regularly attend this church?
________________________________________________
Approximately how long were you a member of this church? ________________________
Were you in good standing with the church? (If an explanation is needed, please use the other side.)
_____________________________________________________________________________________
_____________________________________________________________________________________
Telephone number of the church or its pastor ______________________________________________
Spiritual background:
Please write out a brief description of your conversion to Christ (If you are unsure, please talk with one of the elders. If you need more space, please use the other side of this sheet.)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What evidence do you see which would give you assurance that you are truly His child?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Have you been Scripturally immersed/BAPTIZED following your conversion? ____________________________
If so, what was the date or approximate date of your baptism? _______________________________
What was the name of the church in which you were baptized and the pastor's name who performed the baptism?
__________________________________________________________________________
_____________________________________________________________________________________
If you have not been Scripturally immersed/BAPTIZED following your conversion, do you now wish to be baptized in obedience to Christ's instructions?______________________________________________
How would you describe your present spiritual condition? Please be specific but brief.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What, if any, is your pattern for personal intake of the Word of God and prayer?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Do you have regular family worship in your home? _________If so, how is it done?_____________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Are there habits or issues related to your walk with God that you would like to talk about privately?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Church commitment:
Are you willing to faithfully attend the regular gatherings of the church the leaders deem necessary for the health of the body unless hindered by providence and/or out of town, etc.? _________________________
Are you willing to gladly submit to the spiritual leaders of the church unless conscience demands otherwise?______________________________________________________________________
Will you speak positively about our leaders and the other church members?____________
If difficulties arise in your relationship with others in the church, are you willing to deal biblically with that person rather than gossiping or retaliating in an ungodly way? _____________
Are you willing to use talents and gifts God has given you for the edifying of the body and the promotion of the gospel as God might lead? __________________________________________
Please list any special abilities, gifts or talents which might be used in this way in the future if God leads:
____________________________________________________________________________________
____________________________________________________________________________________
Are you willing to regularly and cheerfully support the Lord's church with your financial gifts? (Note: This question is for believing children also.) ____________________________________________________
While we do not require for membership the level of commitment to our confession that we require of our leadership, we are interested to know if you have any concerns. Are you aware of any disagreement between your beliefs and those in our statement of faith?
_____________________________________________________________________________________
Do you have any questions related to anything on this petition which you would like for us to talk with you about?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Thanks for filling this out. We will discuss this and other issues privately before the membership procedure is concluded
Print your first and last name with middle initial
_______________________________________________
By what name do you prefer to be called?
____________________________________________________
Address_________________________________________________________________________
Home phone________________________________ E‐mail _______________________________
Employment_____________________________________________________________________
Business address ______________________________________________________
Business phone _________________________
Date of application for membership _________________________
Birthdate_________________________
Church and address to which you last belonged
_______________________________________________
______________________________________________________________________________
What was the denomination of this church?
____________________________________________________
Who is this church's present pastor?
___________________________________________________________
When did you last regularly attend this church?
________________________________________________
Approximately how long were you a member of this church? ________________________
Were you in good standing with the church? (If an explanation is needed, please use the other side.)
_____________________________________________________________________________________
_____________________________________________________________________________________
Telephone number of the church or its pastor ______________________________________________
Spiritual background:
Please write out a brief description of your conversion to Christ (If you are unsure, please talk with one of the elders. If you need more space, please use the other side of this sheet.)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What evidence do you see which would give you assurance that you are truly His child?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Have you been Scripturally immersed/BAPTIZED following your conversion? ____________________________
If so, what was the date or approximate date of your baptism? _______________________________
What was the name of the church in which you were baptized and the pastor's name who performed the baptism?
__________________________________________________________________________
_____________________________________________________________________________________
If you have not been Scripturally immersed/BAPTIZED following your conversion, do you now wish to be baptized in obedience to Christ's instructions?______________________________________________
How would you describe your present spiritual condition? Please be specific but brief.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What, if any, is your pattern for personal intake of the Word of God and prayer?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Do you have regular family worship in your home? _________If so, how is it done?_____________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Are there habits or issues related to your walk with God that you would like to talk about privately?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Church commitment:
Are you willing to faithfully attend the regular gatherings of the church the leaders deem necessary for the health of the body unless hindered by providence and/or out of town, etc.? _________________________
Are you willing to gladly submit to the spiritual leaders of the church unless conscience demands otherwise?______________________________________________________________________
Will you speak positively about our leaders and the other church members?____________
If difficulties arise in your relationship with others in the church, are you willing to deal biblically with that person rather than gossiping or retaliating in an ungodly way? _____________
Are you willing to use talents and gifts God has given you for the edifying of the body and the promotion of the gospel as God might lead? __________________________________________
Please list any special abilities, gifts or talents which might be used in this way in the future if God leads:
____________________________________________________________________________________
____________________________________________________________________________________
Are you willing to regularly and cheerfully support the Lord's church with your financial gifts? (Note: This question is for believing children also.) ____________________________________________________
While we do not require for membership the level of commitment to our confession that we require of our leadership, we are interested to know if you have any concerns. Are you aware of any disagreement between your beliefs and those in our statement of faith?
_____________________________________________________________________________________
Do you have any questions related to anything on this petition which you would like for us to talk with you about?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Thanks for filling this out. We will discuss this and other issues privately before the membership procedure is concluded