Membership Application

Name

This address will receive a confirmation email

Phone

Address

Date of Birth

Gender

Are you married?

Married Single Widowed

What is your spouse's name? (Both spouses will need to complete an application.)

Have you repented and trusted Christ as your Lord and Savior?

Yes No Not sure

If yes, when?

Have you been baptized by immersion?

Yes No

Are you currently a member of a church?

Yes No

If so, provide an e-mail address, name, and city of the church.

Have you attended Introducing Immanuel?

Yes No Partially

Why do you want to join Immanuel?

Are you currently attending a Gospel Community Group?

Yes No

If yes, whose group have you been attending?

What is your occupation?

Please list any children and their dates of birth.

Immanuel uses texts and email to keep our membership up to date on upcoming events and to remind members of when they are scheduled to serve on Sunday mornings. Our membership database service, Breeze, requires us to obtain your consent to send you text (SMS) messages.

Our staff works hard to limit the number of texts you receive through Breeze. These texts will always come from 87447.

"By selecting "Yes" below, I am consenting to receive SMS messages through Breeze regarding information and announcements for Immanuel Baptist Church. I understand that message and data rates may apply and message frequency varies. I can opt out by responding STOP at any time. For support I can text HELP to 87447."

Please review the Breeze Privacy Policy and Terms of Service available at breezechms.com for more details.

If you select Yes, you will receive a text from 87447 in the next few days asking you to confirm your consent.

Would you like to receive text (SMS) updates and reminders from Immanuel?

Yes No

Membership Application

Description

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