Church Membership Request - Carolinas Cornerstone

Phone number *

Birthdate *

Address *

Gender

Marital status

Does head of household ask for membership? *

Yes

No

Does spouse ask for membership?

Yes

No

Anniversary date

Household members

Are you a Christian? *

Yes - Head of household

Yes - Spouse

Yes - Children over age 6/yrs

No - Children under age 6/yrs

No - Would like to know more

Are you a Veteran *

Head of household

Spouse Only

Both

Neither

Have you been baptized? *

Yes - Head of household

Yes - Spouse

Yes - Child over 6/yrs desires baptism

No but interested in more info

Neither

Photo permission *

Yes - Whole family

No - Whole family

Yes - Kids only

No - Kids only

Is there anything else you would like for us to know?

Do you consent to receive text messages? *

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