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at True Divine
We understand that choosing a home church can be difficult. We are happy to walk through this with you!
Membership Interest Form
Membership Date
*
Month
Day
Year
Name
*
First
Last
Date of Birth
*
Cell Phone #
*
Home Phone #
Email
*
Enter Email
Confirm Email
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
If you are married, does your spouse wish to be a member also?
*
Yes
No
Not Married
Spouse Name
*
First
Last
Spouse Email
*
Spouse Phone
*
Spouse Date of Birth
*
Emergency Contact Name
*
Emergency Contact Phone
*
How many children are becoming members with you?
*
None
One
Two
Three
Four
Five
Six
Seven
Child 1 Name
*
First
Last
Child 1 Date of Birth
*
Child 1 is
*
Male
Female
Child 2 Name
*
First
Last
Child 2 Date of Birth
*
Child 2 is
*
Male
Female
Child 3 Name
*
First
Last
Child 3 Date of Birth
*
Child 3 is
*
Male
Female
Child 4 Name
*
First
Last
Child 4 Date of Birth
*
Child 4 is
*
Male
Female
Child 5 Name
*
First
Last
Child 5 Date of Birth
*
Child 5 is
*
Male
Female
Child 6 Name
*
First
Last
Child 6 Date of Birth
*
Child 6 is
*
Male
Female
Child 7 Name
*
First
Last
Child 7 Date of Birth
*
Child 7 is
*
Male
Female
How did you hear about us?
*
Family Member
Internet Search
Church Member
Social Media
Visitor
