Name:

Date: Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2005 2006 2007 2008 2009

Address:

City: State: ZIP:

Day Phone: Evening Phone:

Email

Occupation:

Employer:

Birthdate: Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Marital Status: Single Married Separated Divorced Remarried Widowed

Please list the members of your immediate family:

Do you regularly attend the Grand Island Free Evangelical Free Church?
Yes No

How long have you been attending?

Which service(s) do you regularly attend?

Sunday Worship 8:30 am Sunday Worship 11:00 am

With which ministries are you currently involved and/or serving?

Rock Solid Kids Club Sunday School Timberlake Ranch Camp Free Life - Middle School Free Life - High School Women's Bible Study Women's Leadership Team Men's Bible Study Promise Keepers R.O.C.S. Bible Study Young Life Cafe Young Couples

SALT Single and Single Again Free @ Free Empty Nesters Parents Under Pressure Parents of Young Families CEOs Intergenerational Bible Elective Worship Old Testament Studies Leader Training Other

What other churches have you attended regularly during the past five years?
Church Name: State: Select State Alaska Alabama Alberta Arkansas Arizona California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Iowa Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Missouri Mississippi Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Outside US
Church Name: State: Select State Alaska Alabama Alberta Arkansas Arizona California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Iowa Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Missouri Mississippi Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Outside US
Church Name: State: Select State Alaska Alabama Alberta Arkansas Arizona California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Iowa Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Missouri Mississippi Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Outside US
Church Name: State: Select State Alaska Alabama Alberta Arkansas Arizona California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Iowa Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Missouri Mississippi Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Outside US
Church Name: State: Select State Alaska Alabama Alberta Arkansas Arizona California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Iowa Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Missouri Mississippi Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Outside US

Are you presently holding membership in another church? Yes No

If yes, will you notify them of your membership with us? Yes No

To what other organizations do you currently belong?


Briefly share when and how you become a Christian. Be sure to include what steps with God you took in becoming a Christian.

Usually a brief form of your testimony will be published in the church newsletter. Do we have your permission to do this? Yes No

Have you been involved in any membership events?

Membership Sunday	Yes No
Christianity 101	Yes No
Serving 101	Yes No

Have you been baptized since becoming a Christian? Yes No

If not, are you willing to be baptized? Yes No

Are you in complete agreement with our church Confession of Faith? Yes No Read our Confession of Faith

If not, please explain:


Have your read the Constitution and Bylaws of the Grand Island Evangelical Free Church, and will you subscribe to them fully?
Yes No

Covenant With Christ and the Church

I acknowledge myself to be a sinner in the sight of God, in need of His forgiveness and cleansing. I place my faith and trust in Jesus Christ, the Son of God, and in His sacrifice on my behalf as an atonement for my sins. I have accepted Jesus Christ as my Savior, and depend upon Him alone for salvation according to the message of the Gospel. I dedicate my life to
Christ, and proclaim him to be my Lord and Master. I resolve and promise, in humble reliance upon the grace and guidance of the Holy Spirit, to live my life according to the principles and instructions of God’s Word, the Bible. I commit myself to following Christ and honoring God in my actions, thoughts, and relationships. I promise to honor Christ in His Church by faithfully participating in worship with my brothers and sisters in Christ. I pledge to serve God by using my gifts and abilities to serve others in an ongoing ministry role. I promise to support the ministry of the Church through the cheerful and faithful giving of my tithes and offerings. Finally, I submit myself to the authority and discipline of the Church, and promise to further its purity and peace.

Please Initial for Acceptance
Date: Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2005 2006 2007 2008 2009