Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Age *

18-25

26-35

36-45

46-55

56-65

66+

Family Information *

Please select which best applies to you.

I am Married

I am Single

I am Separated from my Spouse

I am Divorced

I am Remarried

I am Unmarried but Living with Someone

Have you been baptized as a believer? *

Yes

No

Relationship to Other Churches - Are you presently a member of another church? *

Yes

No

Relationship to Other Churches - If you are currently a member of another church, are you considering a transfer of membership?

Yes

No

Expectations and Commitments we ask our members to make - Are you in basic agreement with the Christ Community Church statement of faith? *

Yes

No

Expectations and Commitments we ask our members to make: Are you fully supportive of our church’s emphasis on world-wide evangelism and church planting? *

Yes

No

Expectations and Commitments we ask our members to make:Will you fully support our church through regular worship attendance, financial giving (as God enables you) cooperation with leadership and using your gifts to serve? *

Yes

No

Expectations and Commitments we ask our members to make: Will you consider membership in a Life Group? *

Yes

No

Already in a Life Group