MEMBER
INFORMATION:
Joined as:
Christian Experience
Candidate
for Baptism
Referred/Invited By:
Name
(First, MI,
Last):
Maiden Name:
Date of Birth (mm/dd/yyyy):
Gender:
Male
Female
Marital Status:
Single
Married
Widow
Divorced
Street
Address:
Apt/Bldg#:
City, State, Zip Code:
Home Phone:
Cell Phone:
Home E-Mail:
Year Joined TNH:
SPOUSE
INFORMATION:
Name:
Date of Birth (mm/dd/yyyy):
Cell
Phone:
Member of TNH:
Yes
No
GENERAL
INFORMATION:
Occupation:
Work
Phone:
Work E-Mail:
City, State, Zip Code:
EMERGENCY
INFORMATION:
Name
of a relative not residing with you:
Address:
City, State, Zip Code:
Phone:
Relationship:
Important Medical Info
(Allergies/Special
Conditions):
CHILDREN
IN HOUSEHOLD INFORMATION:
CHILD 1:
Name (First and Last):
Date of Birth
(mm/dd/yyyy),
Age:
School:
Member
of TNH:
Yes
No
Baptized:
Yes
No
CHILD
2:
Name (First and Last):
Date of Birth
(mm/dd/yyyy),
Age:
School:
Member
of TNH:
Yes
No
Baptized:
Yes
No
CHILD
3:
Name (First and Last):
Date of Birth
(mm/dd/yyyy),
Age:
School:
Member
of TNH:
Yes
No
Baptized:
Yes
No
CHILD
4:
Name (First and Last):
Date of Birth
(mm/dd/yyyy),
Age:
School:
Member
of TNH:
Yes
No
Baptized:
Yes
No
CURRENT
MINISTRY INVOLVEMENT(check
all that apply):
Announcers
Audio
Visual
Christian
Ed
Counseling
Culinary
Arts
Food
Bank
Golden
Circle
Greeters
Marriage
Mission
Mothers
Music
Nurses
Orientators
Pastoral
Care
Praise
Dancers
Prison
Sacred
Sisters
Security
Shepherd's
Ushers
Watchmen
Welcome
Youth/Children
Other
None
Leadership:
Minister
Deacon
Trustee
OTHER
FAMILY MEMBERS OF THIRD NEW HOPE
(PLEASE
LIST):
1. Name:
Relationship:
2. Name:
Relationship:
3.
Name:
Relationship:
4.
Name:
Relationship:
5.
Name:
Relationship:
6.
Name:
Relationship:
7.
Name:
Relationship:
8.
Name:
Relationship:
Thank
you for your cooperation in this endeavor to assist
us in keeping membership information current. We recognize
the sensitivity of your right to privacy and will
guarantee that your information is not for general
distribution but for the office records and for ministry
work and will be held in the strictest confidence.