EmailMeForm
Church Membership Form
New Comers Ministry | newcomers@stjamescmbc.org
Ministry Lead: Cynthia Galvin | Pastoral Lead: Rev. Leon McCowan, PhD
Senior Pastor: Dr. B.W. McClendon, Sr.
Date
*
MM
/
DD
/
YYYY
Name
*
First
Last
Marital Status
*
Married
Single
Widowed
Age
*
Date of Birth
*
MM
/
DD
/
YYYY
Membership Decision (check all that apply):
*
Baptism
Statement
Letter
Watchcare
What Ministries are you interested in?
*
Spouse/Fiancée Information
Spouse/Fiancée Name
First
Last
Spouse/Fiancée Joining?
Yes
No
Spouse/Fiancée Age
Spouse/Fiancée Date of Birth
MM
/
DD
/
YYYY
Children Information
Child1 Name
First
Last
Child1 Email
Child1 Age
Child1 Date of Birth
MM
/
DD
/
YYYY
Child1 School
Child2 Name
First
Last
Child2 Email
Child2 Age
Child2 Date of Birth
MM
/
DD
/
YYYY
Child2 School
Child3 Name
First
Last
Child3 Email
Child3 Age
Child3 Date of Birth
MM
/
DD
/
YYYY
Child3 School
Child4 Name
First
Last
Child4 Email
Child4 Age
Child4 Date of Birth
MM
/
DD
/
YYYY
Child4 School
Contact Information
Mailing Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Primary Phone
*
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-
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Alternate Phone
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-
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Primary Email
*
Alternate Email
Photo Upload
OPTIONAL: Upload a photo or selfie. Your photo will be used during our quarterly introduction of new members during Sunday Worship Service. (Note that this is voluntary and not required.)
