Membership Application Name(Required) First Last PhoneEmail(Required) Address(Required) Street Address City State / Province / Region ZIP / Postal Code Birthdate(Required) MM slash DD slash YYYY Place of Employment(Required)Spouse Name First Last Anniversary Date MM slash DD slash YYYY Children's Names & BirthdatesHave you committed your life to Christ and trusted Him for salvation?(Required) Yes No If yes, briefly state the circumstances surrounding your putting your faith in Jesus Christ as your personal Savior.(Required)Have you been baptized after conversion?(Required) Yes No If yes, when and where?(Required)Have you completed the "Membership Matters" Class?(Required) Yes No Date of Completion(Required) MM slash DD slash YYYY Have you been a member of another church?(Required) Yes No If yes, when and where?(Required)5. Are you in the process of being disciplined by another church?(Required) Yes No Briefly state why you desire to become a member of Bethany Baptist Church.(Required)Digital Signature(Required) I Affirm.I affirm that I have read the Bethany Church Constitution and am in agreement with it. I affirm that I have read the Bethany Doctrinal Statement and am in agreement with each statement. Date MM slash DD slash YYYY CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
