Name *

First Name

Last Name

Birthday *

MM

DD

YYYY

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I need to be baptized.

I'm interested in having my child/ren baptized.

Membership Transfer *

Are you transferring your membership from another church?

Yes

No

Spouse's Name

First Name

Last Name

Anniversary

MM

DD

YYYY

Membership Class Completion Date *

MM

DD

YYYY

Membership Questions *

Do you confess Jesus Christ as your Savior and promise to follow him as Lord?

Yes

No

*

Do you accept the Holy Scriptures, the Old and New Testaments, as the word of God and the only perfect rule for faith, doctrine, and conduct?

Yes

No

*

Do you intend to live as a faithful member of Hillside Community Church and the Evangelical Covenant Church?

Yes

No