New Member Information Sheet

First Name

Last Name

Preferred Name

Gender

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Birthdate

Cell Number

Home Phone

Occupation

Current Employer

Do You Currently or Have You Previously Served in the Military?

Yes

Baptized?

Yes

Date of Baptism, if Applicable

Name of Previous Church

Marital Status

Anniversary Date

Is Your Spouse Also Placing Membership at This Time?

Yes

N/A

Spouse's Information

Spouse First Name

Spouse Last Name

Spouse Preferred Name

Gender

Spouse Birthdate

Spouse Email

Spouse Cell Number

Spouse Occupation

Spouse Employer

Do They Currently or Have They Ever Served in the Military?

Yes

Are They Baptized?

Yes

Date of Baptism, if Applicable

Name of Previous Church

Do You Have Children or Other Members Living in Your Household?

Yes

List All Additional Household Members

First Name

Last Name

Gender

Relationship to Head of Household

Birthdate

School and Grade if Applicable

Date of Baptism if Applicable

I consent to have images of me and/or my family taken at events and services of the Hardin Valley Church of Christ used for marketing purposes, including their website, social media platforms, and mobile app.

Consent

Do Not Consent

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