Application for Church Membership - Russellville Baptist Church

Date

First Name

Last Name

I have accepted Christ as my personal Lord and Savior, and I desire membership in this church by:

Baptism

Statement of Faith

Letter

If Letter - Enter the church transferring from below:

Address of transferring church

Apartment, suite, etc.

City

State

Zip/Postal Code

Household Information

Head of Household Information

Head of Household - First Name

Last Name

Phone Number

Email

Birthdate

Spouse Information

Spouse - First Name

Last Name

Phone Number

Email

Birthdate

Anniversary

Household Address

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Children (Dependents at Home)

First Name

Last Name

Birthdate

Date of Baptism